Jessica R. Talles-Eriksen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

007940 Issued in GA

Practice address

4750 Waters Ave Ste 202
Savannah, GA 31404

Phone

(912) 350-7412

Fax

(912) 350-7297

NPI assigned

Mar 1, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Savannah Multispecialty Associates LLCGroup PAC ID 3678836558, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Savannah Multispecialty Associates, LLC

  • Trauma Surgery Physician
  • Savannah, GA
  • NPI 1528571320
  Medicare reassignment Care Compare group
• MPPG, Inc.

  • Family Medicine Physician
  • Savannah, GA
  • NPI 1033131172
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Savannah Health Services, LLC

  dba Memorial Health University Medical Center

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1053824292
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1699135848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 WATERS AVE STE 202",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046278",
            "telephone_number": "912-350-7412",
            "fax_number": "912-350-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 WATERS AVE STE 202",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31404",
            "telephone_number": "912-350-7412",
            "fax_number": "912-350-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLES-ERIKSEN",
        "first_name": "JESSICA",
        "middle_name": "R.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-01",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "007940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly L Tackett, PHARMD
• Sondra Tackett, RD
• Tackl-It LLC
• Amanda Patricia Talalaj
• Julie Joyner Talbot, PT,DPT, PCS
• Toni M Talley
• Ashleigh Tallman
• Jeff Tamanini, PT
• Kevin Tamucci, MD
• Josefina C. Tan, M.D.

• Physician Assistant in Savannah, GA
• Providers in Savannah, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.

Verify at the official NPI Registry.