Active NPI
Jennifer I Bardales, PA-C
- Medical Physician Assistant
- Sinking Spring, PA
National Provider Identifier
1669727426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- MA057314
- Practice address
- 4906 Penn Ave Ste 202
Sinking Spring, PA 19608-8622 - Phone
- (610) 484-3761
- NPI assigned
- Jul 18, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | C0004793 | MD | |
| Medical Physician Assistant | 363AM0700X | MA057314 | PA | Primary |
| Physician Assistant | 363A00000X | 54363 | CA |
Addresses
Primary practice location
4906 Penn Ave Ste 202
Sinking Spring, PA 19608-8622
Mailing address
4906 Penn Ave Ste 202
Sinking Spring, PA 19608-8622
Other names 1
- Jennifer I Runyon
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150203000324 | PA | Practitioner - Physician Assistant | 6800042474 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54363 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Solano Regional Medical Group, Inc. | Physician Assistant | Past | Accepting new patients |
| Nathan R. Howe, MD | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- General Acute Care Hospital
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-
- Family Medicine Physician
- Fairfield, CA
- NPI 1528085578
Physician Assistant
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Clear Dermatology LLC
Practice addresses (Care Compare)
4906 Penn Ave
Suite 202
Sinking Spring, PA 19608-8609
Phone (610) 484-3761
Hospital & facility affiliations
- Reading Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773273600000",
"number": "1669727426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4906 PENN AVE STE 202",
"city": "SINKING SPRING",
"state": "PA",
"postal_code": "196088622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4906 PENN AVE STE 202",
"city": "SINKING SPRING",
"state": "PA",
"postal_code": "196088622",
"telephone_number": "610-484-3761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARDALES",
"first_name": "JENNIFER",
"middle_name": "I",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-18",
"last_updated": "2026-03-12",
"certification_date": "2026-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MD",
"license": "C0004793",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA057314",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "54363",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "RUNYON",
"middle_name": "I",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Sinking Spring, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.