Individual provider Active NPI

Jennifer L Urena, PA

  • Specialist
  • Las Vegas, NV
National Provider Identifier
1740512078
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PA1198 Issued in NV
Practice address
3121 S Maryland Pkwy
Suite 420
Las Vegas, NV 89109-2307
Phone
(702) 796-8669
Fax
(702) 796-9517
NPI assigned
Feb 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PA1198 NV Primary

Addresses

Primary practice location

3121 S Maryland Pkwy
Suite 420
Las Vegas, NV 89109-2307

Mailing address

3121 S Maryland Pkwy
Suite 420
Las Vegas, NV 89109-2307
Phone (702) 796-8669

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
I20171115000706 CA Practitioner - Physician Assistant 1951430412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

10670 Wexford St
San Diego, CA 92131-3940
Phone (858) 621-4002

Hospital & facility affiliations

  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53133CAMDDentist
PA1198NVMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Nov 6, 2017 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Nov 6, 2017 Accepting new patients
Scott a. Slavis, M.D., P.C. Past Accepting new patients
Dhanvantari Trehan Salts of the Earth PC Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Dr Shetty PLLC PastSince Jun 1, 2024 Accepting new patients

Locations

1400 E Palomar St
Chula Vista, CA 91913
Phone (619) 397-3077

10670 Wexford St
San Diego, CA 92131
Phone (858) 621-4010

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

Organizations & group practices 8

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 2

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": "1265846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1740512078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 S MARYLAND PKWY",
            "address_2": "SUITE 420",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092307",
            "telephone_number": "702-796-8669",
            "fax_number": "702-796-9517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 S MARYLAND PKWY",
            "address_2": "SUITE 420",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092307",
            "telephone_number": "702-796-8669",
            "fax_number": "702-796-9517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URENA",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-11",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "PA1198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.