Individual provider Active NPI

Jenna M Ternes, PA-C

  • Medical Physician Assistant
  • Mesa, AZ
National Provider Identifier
1750632964
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5234 Issued in AZ
Practice address
1432 S Dobson Rd Ste 301
Mesa, AZ 85202
Phone
(480) 412-9400
NPI assigned
Sep 27, 2012
Last updated
May 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5234 AZ Primary

Addresses

Primary practice location

1432 S Dobson Rd Ste 301
Mesa, AZ 85202

Mailing address

1432 S Dobson Rd Ste 301
Mesa, AZ 85202-4773
Phone (480) 412-9400

Other practice location 1

2141 E Warner Rd
Suite 101
Tempe, AZ 85284-3493
Phone (480) 610-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20121019000067 AZ Practitioner - Physician Assistant 8123278686 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Super Specialists Arizona LLC CurrentSince Apr 1, 2015 Accepting new patients
Southwest Kidney Institute, PLC Past Accepting new patients

Locations

5310 W Thunderbird Rd
Ste 110
Glendale, AZ 85306
Phone (602) 865-4065

14419 W McDowell Rd
Ste E102
Goodyear, AZ 85395
Phone (623) 465-6030

1432 S Dobson Rd
Ste 301
Mesa, AZ 85202
Phone (480) 412-7120

1432 S Dobson Rd
Ste 509
Mesa, AZ 85202
Phone (480) 412-6970

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1750632964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 S DOBSON RD STE 301",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024773",
            "telephone_number": "480-412-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 S DOBSON RD STE 301",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85202",
            "telephone_number": "480-412-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2141 E Warner Rd",
            "address_2": "SUITE 101",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852843493",
            "country_code": "US",
            "telephone_number": "480-610-6100",
            "fax_number": "480-464-0189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERNES",
        "first_name": "JENNA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-27",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.