Individual provider Active NPI

Jenna Olsen Rojek, PA-C

  • Physician Assistant
  • Myrtle Beach, SC
National Provider Identifier
1710740204
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
199 VLG Ctr Blvd Ste 200
Myrtle Beach, SC 29579-6750
Phone
(843) 738-0500
NPI assigned
Feb 6, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

199 VLG Ctr Blvd Ste 200
Myrtle Beach, SC 29579-6750

Mailing address

199 VLG Ctr Blvd Ste 200
Myrtle Beach, SC 29579-6750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20240822001682 SC Practitioner - Physician Assistant 9032658083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Dermatology Institute LLCGroup PAC ID 4981005063, 4 clinicians

Practice addresses (Care Compare)

199 Village Ctr Blvd
Suite 200
Myrtle Beach, SC 29579

199 Village Ctr Blvd
Suite 200
Myrtle Beach, SC 29579-3589
Phone (843) 738-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1710740204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 VLG CTR BLVD STE 200",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 VLG CTR BLVD STE 200",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796750",
            "telephone_number": "843-738-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROJEK",
        "first_name": "JENNA",
        "middle_name": "OLSEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.