Individual provider Active NPI

Jenna A Pataluna, PAC

  • Medical Physician Assistant
  • Warrenton, VA
National Provider Identifier
1790037109
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110004017 Issued in VA
Practice address
52 W Shirley Ave
Warrenton
Warrenton, VA 20186-3008
Phone
(540) 347-9220
Fax
(540) 347-0492
NPI assigned
Oct 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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 0110004017 VA Primary

Addresses

Primary practice location

52 W Shirley Ave
Warrenton
Warrenton, VA 20186-3008

Mailing address

52 W Shirley Ave
Warrenton
Warrenton, VA 20186-3008
Phone (540) 347-9220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20121114000592 VA Practitioner - Physician Assistant 4587815899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Ridge Orthopaedic Associates PCGroup PAC ID 6800885310, 39 clinicians

Practice addresses (Care Compare)

52 W Shirley Ave
Warrenton, VA 20186-3008
Phone (540) 347-9220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110004017VAMDMedical Physician 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 3

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": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1790037109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 W SHIRLEY AVE",
            "address_2": "WARRENTON",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201863008",
            "telephone_number": "540-347-9220",
            "fax_number": "540-347-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 W SHIRLEY AVE",
            "address_2": "WARRENTON",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201863008",
            "telephone_number": "540-347-9220",
            "fax_number": "540-347-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATALUNA",
        "first_name": "JENNA",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110004017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, VA

Sources for this page

Verify at the official NPI Registry.