Individual provider Active NPI

Jennifer Fabrizi, PA

  • Physician Assistant
  • Mount Pleasant, SC
National Provider Identifier
1780782573
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1048 Issued in SC
Practice address
612 Seacoast Pkwy
Mt Pleasant, SC 29464-8247
Phone
(843) 881-4440
Fax
(843) 884-8540
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0007574 NY
Physician Assistant 363A00000X 1048 SC Primary

Addresses

Primary practice location

612 Seacoast Pkwy
Mt Pleasant, SC 29464-8247

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

1814 Crowne Commons Way Ste E7
Johns Island, SC 29455-4932
Phone (843) 881-4440

Other names 1

  • Jennifer Cziprusz Former name

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
I20200629001528 SC Practitioner - Physician Assistant 7315932779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

612 Seacoast Pkwy
Mt Pleasant, SC 29464-8247
Phone (843) 881-4440

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7574NYMDClinical Neuropsychologist
0007574NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. CurrentSince Aug 2, 2024 Accepting new patients
Forefront Dermatology, S.C. CurrentSince Aug 2, 2024 Accepting new patients
Forefront Dermatology, S.C. Past Accepting new patients
Schweiger Dermatology PLLC PastSince Aug 9, 2021 Accepting new patients

Locations

1814 Crowne Commons Way
Ste E7
Johns Island, SC 29455
Phone (843) 881-4440

612 Seacoast Pkwy
Mt Pleasant, SC 29464
Phone (843) 881-4440

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Bin 88617
Milwaukee, WI 53288

Interoperability endpoints

  • Direct secure messaging: jfabrizi@directaddress.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1780782573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 SEACOAST PKWY",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294648247",
            "telephone_number": "843-881-4440",
            "fax_number": "843-884-8540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1814 Crowne Commons Way Ste E7",
            "address_purpose": "LOCATION",
            "city": "Johns Island",
            "state": "SC",
            "postal_code": "294554932",
            "country_code": "US",
            "telephone_number": "843-881-4440",
            "fax_number": "843-737-5288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FABRIZI",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "0007574",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "CZIPRUSZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.