Individual provider Active NPI

Jill Bender, PA

  • Surgical Physician Assistant
  • Mansfield, OH
National Provider Identifier
1831260421
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50002549 Issued in OH
Practice address
335 Glessner Ave
Mansfield, OH 44903-2269
Phone
(419) 524-8151
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50002549 OH Primary

Addresses

Primary practice location

335 Glessner Ave
Mansfield, OH 44903-2269

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other identifiers 1

IdentifierTypeStateIssuer
0069505MedicaidOH

Other names 1

  • Jill Carr Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbender122154@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20070216000123 OH Practitioner - Physician Assistant 8628170925 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Central Ohio Family Care Center IncGroup PAC ID 3274437082, 194 clinicians

Practice addresses (Care Compare)

269 Portland Way S
Galion, OH 44833-2312
Phone (419) 468-4841

Hospital & facility affiliations

  • Galion Community Hospital Hospital, Galion, OH, CCN 361325
  • Avita Ontario Hospital, Ontario, OH, CCN 360365
  • Bucyrus Community Hospital Hospital, Bucyrus, OH, CCN 361316

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50002549OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jan 1, 2021 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

Organizations & group practices 3

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1831260421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 GLESSNER AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032269",
            "telephone_number": "419-524-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDER",
        "first_name": "JILL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2022-01-25",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50002549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069505",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbender122154@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "335 Glessner Ave",
            "city": "Mansfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "449032269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "CARR",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.