NPIMap

Individual provider Active NPI

Jessica Israelsen Brantley, PA-C

  • Physician Assistant
  • Chandler, AZ
National Provider Identifier
1821641770
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7749 Issued in AZ
Practice address
725 S Dobson Rd Ste A105
Chandler, AZ 85224-5680
Phone
(480) 786-2827
NPI assigned
Jul 19, 2019
Last updated
Jan 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7749 AZ Primary

Addresses

Primary practice location

725 S Dobson Rd Ste A105
Chandler, AZ 85224-5680

Mailing address

725 S Dobson Rd Ste A105
Chandler, AZ 85224-5680
Phone (480) 786-2827

Other practice location 1

1760 E Pecos Rd Ste 101
Gilbert, AZ 85295-3201
Phone (480) 855-8060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WI, IL, CO, TX5 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20200403002878 AZ Practitioner - Physician Assistant 2163851650 Reassigns benefits to 10 organizations
I20230220002106 WI Practitioner - Physician Assistant 2163851650
I20230221002398 IL Practitioner - Physician Assistant 2163851650
I20230517003165 CO Practitioner - Physician Assistant 2163851650 Reassigns benefits to 2 organizations
I20240108005831 TX Practitioner - Physician Assistant 2163851650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7525 Metropolitan Dr
Suite 306
San Diego, CA 92108-4404

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
75.71
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
75.71
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7749AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Smi Imaging LLC CurrentSince Feb 14, 2022 Accepting new patients
Smi Imaging LLC CurrentSince Nov 30, 2022 Accepting new patients
Spinezone Medical Fitness, Inc. Past Accepting new patients
Livara Health Medical Group NJ, PC Past Accepting new patients

Locations

16220 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254

939 N Broadway
Denver, CO 80203
Phone (303) 633-1280

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1821641770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S DOBSON RD STE A105",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245680",
            "telephone_number": "480-786-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S DOBSON RD STE A105",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245680",
            "telephone_number": "480-786-2827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1760 E Pecos Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852953201",
            "country_code": "US",
            "telephone_number": "480-855-8060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "JESSICA",
        "middle_name": "ISRAELSEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.