Individual provider Active NPI

Jennifer E Winter, PA-C

  • Physician Assistant
  • Olympia, WA
National Provider Identifier
1740280056
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA100003762 Issued in WA
Practice address
304 W Bay Dr NW
Suite 301
Olympia, WA 98502-4958
Phone
(360) 413-8760
Fax
(360) 413-8839
NPI assigned
Jul 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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 PA100003762 WA Primary

Addresses

Primary practice location

304 W Bay Dr NW
Suite 301
Olympia, WA 98502-4958

Mailing address

304 W Bay Dr NW
Suite 301
Olympia, WA 98502-4958
Phone (360) 413-8760

Other identifiers 2

IdentifierTypeStateIssuer
GAB20351OtherWAMEDICARE
8214603MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100325001066 WA Practitioner - Physician Assistant 3779619002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology and Allergy SpecialistsGroup PAC ID 1254302698, 6 clinicians

Practice addresses (Care Compare)

304 W Bay Dr NW
Suite 301
Olympia, WA 98502-4957
Phone (360) 413-8760

304 W Bay NW
Suite 301
Olympia, WA 98502-4957

Hospital & facility affiliations

  • Mason General Hospital & Family of Clinics Hospital, Shelton, WA, CCN 501336
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as individual
Quality
77.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA100003762WAMDPhysician Assistant

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1740280056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W BAY DR NW",
            "address_2": "SUITE 301",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024958",
            "telephone_number": "360-413-8760",
            "fax_number": "360-413-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W BAY DR NW",
            "address_2": "SUITE 301",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024958",
            "telephone_number": "360-413-8760",
            "fax_number": "360-413-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTER",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA100003762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GAB20351",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8214603",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.