Jennifer A Holt, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

150000 Issued in AK

Practice address

3745 Geist Rd
Fairbanks, AK 99709-3554

Phone

(907) 456-3338

NPI assigned

May 27, 2008

Last updated

Nov 19, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

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

Specialty

Physician Assistant

Education

University of California, Davis School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanana Valley Clinic LLCGroup PAC ID 5698056901, 142 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

Merit-based Incentive Payment System (MIPS)

Final score

92.86 of 100Reported as group

Quality

94.88

Promoting interoperability

100

Improvement activities

40

Cost

79.39

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.holt@direct.tananavalley.nextgenshare.com
• Direct secure messaging: mckinleyorthopedics.jenniferholt@158245.advancedmd-direct.com

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.

• Tanana Valley Clinic LLC

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1922559558
  Medicare reassignment Care Compare group NPD
• McKinley Orthopedic and Sports Medicine, LLC

  • Orthopaedic Surgery Physician
  • Fairbanks, AK
  • NPI 1760938021
  Medicare reassignment
• Tanana Valley Clinic LLC

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1073081485
  NPD

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

• Fairbanks Memorial Hospital, LLC

  • General Acute Care Hospital
  • Fairbanks, AK
  • NPI 1720537178
  Care Compare affiliation

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1801054879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3745 GEIST RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093554",
            "telephone_number": "907-456-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 GEIST RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093554",
            "telephone_number": "907-456-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AK",
            "license": "150000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500605570",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larissa Ladonna Hollowell
• Fredrick Holmberg
• Katelyn Tamara Holmberg
• Shirley May Holmberg, BA
• Darla K Holmes
• Mikaila Holt
• Tracie Holt, YOUTH COUNSELORS
• Isabel Jordan Hom
• Stephanie Homan, PA-C
• Home Town Physical Therapy, LLC

• Surgical Physician Assistant in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Surgical Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.