Individual provider Active NPI

Jennifer L. Greening, PA

  • Physician Assistant
  • Watsonville, CA
National Provider Identifier
1700827342
Registry record updated Mar 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14820 Issued in CA
Practice address
75 Nielson St
Em Dept
Watsonville, CA 95076-2468
Phone
(831) 761-5613
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14820 CA Primary

Addresses

Primary practice location

75 Nielson St
Em Dept
Watsonville, CA 95076-2468

Mailing address

75 Neilson St
Emergency Department
Watsonville, CA 95076-2468
Phone (831) 761-5631

Other identifiers 1

IdentifierTypeStateIssuer
1700827342MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20050331001168 CA Practitioner - Physician Assistant 0143277277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
14820CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Mar 1, 2015 Accepting new patients
Emergency Medical Group Past Accepting new patients
Apogee Medical Group California Inc. Past Accepting new patients
Watsonville Emergency Medical Group Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

75 Nielson St
#D
Watsonville, CA 95076
Phone (831) 761-5613

75 Nielson St
Watsonville, CA 95076
Phone (831) 724-4741

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426982400000",
    "number": "1700827342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 NEILSON ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762468",
            "telephone_number": "831-761-5631",
            "fax_number": "831-761-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NIELSON ST",
            "address_2": "EM DEPT",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762468",
            "telephone_number": "831-761-5613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENING",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700827342",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.