Jennifer Weiss, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2024-0065 Issued in NM

Practice address

630 W Maple St
Farmington, NM 87401-6113

Phone

(505) 609-6349

Fax

(505) 599-4679

NPI assigned

Aug 7, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC, VA, NM, WI4 enrollments

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 4

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agnesian Healthcare Inc 392 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Agnes Hospital-Fond Du Lac Hospital, Fond Du Lac, WI, CCN 520088

Merit-based Incentive Payment System (MIPS)

Final score

80.52 of 100Reported as group

Quality

56.13

Promoting interoperability

98

Improvement activities

40

Cost

80.61

Merit-based Incentive Payment System (MIPS)

Final score

90.97 of 100Reported as group

Quality

79.73

Promoting interoperability

100

Improvement activities

40

Cost

78.87

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jweiss535939@direct-ehr-ssmhc.com

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.

• Agnesian Healthcare, Inc

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1346228541

  WI

  Medicare reassignment Care Compare group
• San Juan Regional Medical Center Inc

  • Gastroenterology Physician
  • Farmington, NM
  • NPI 1639662901

  NM

  Medicare reassignment NPD
• Agnesian Healthcare Inc

  • Community/Retail Pharmacy
  • Waupun, WI
  • NPI 1366417917
  Care Compare group NPD
• Gastroenterology Associates of Northern Virginia, LLC

  • Gastroenterology Physician
  • Fairfax, VA
  • NPI 1205884368

  DC, VA

  Medicare reassignment
• Winchester Medical Center

  • Critical Care Medicine (Internal Medicine) Physician
  • Winchester, VA
  • NPI 1679711261

  VA

  Medicare reassignment
• Agnesian Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Ripon, WI
  • NPI 1073842571
  Care Compare group
• Agnesian Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Fond Du Lac, WI
  • NPI 1083676217
  Care Compare group
• Agnesian Healthcare Inc

  • Community/Retail Pharmacy
  • Fond Du Lac, WI
  • NPI 1104891746
  Care Compare group
• Agnesian Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Ripon, WI
  • NPI 1316212954
  Care Compare group
• Agnesian Healthcare Inc

  • Community/Retail Pharmacy
  • Fond Du Lac, WI
  • NPI 1326013962
  Care Compare group
• Agnesian Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Fond Du Lac, WI
  • NPI 1437110988
  Care Compare group
• Agnesian Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • N Fond Du Lac, WI
  • NPI 1679516454
  Care Compare group

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

• Agnesian Healthcare, Inc

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1346228541

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1811244007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844088",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844088",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016113",
            "telephone_number": "505-609-6349",
            "fax_number": "505-599-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110003901",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2024-0065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO BOARD OF MEDICINE",
            "identifier": "PA2024-0065",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "0110003901",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Waymire, M.D.
• Matthew Raymond Webb, O.D.
• John R Webster, MD
• Emily R Wegener, RPH
• Jaime Weiss, PHARM D
• Zachary Weiss, MD
• Welbrook Senior Living Farmington LLC
• Jamie Welch
• Larry Ray Welling, M.D.
• Amanda M Wells

• All providers in Farmington, NM
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.