Individual provider Active NPI

Jenna Natalie Queller, MD

  • Dermatology Physician
  • Boca Raton, FL
National Provider Identifier
1851654990
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME131873 Issued in FL
Practice address
7000 W Palmetto Park Rd Ste 105
Boca Raton, FL 33433-3429
Phone
(561) 783-3376
Fax
(561) 430-3129
NPI assigned
Jun 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME131873 FL Primary

Addresses

Primary practice location

7000 W Palmetto Park Rd Ste 105
Boca Raton, FL 33433-3429

Mailing address

7000 W Palmetto Park Rd Ste 105
Boca Raton, FL 33433-3429
Phone (561) 783-3376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200409000616 FL Practitioner - Dermatology 4385937549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7000 W Palmetto Park Rd
Suite 105
Boca Raton, FL 33433-3429
Phone (561) 783-3376

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions253
Skin biopsy58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME131873FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jenna Queller MD PA Dermatology CurrentSince Feb 1, 2023 Accepting new patients

Locations

7000 W Palmetto Park Rd
Ste 105
Boca Raton, FL 33433
Phone (561) 783-3376

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.

NPI Registry JSON

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1851654990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 W PALMETTO PARK RD STE 105",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333429",
            "telephone_number": "561-783-3376",
            "fax_number": "561-430-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 W PALMETTO PARK RD STE 105",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333429",
            "telephone_number": "561-783-3376",
            "fax_number": "561-430-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUELLER",
        "first_name": "JENNA",
        "middle_name": "NATALIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME131873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.