Active NPI
Jennifer Diane Majewski, PA
- Physician Assistant
- North East, PA
National Provider Identifier
1881693661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA051409
- Practice address
- 2060 N Pearl St
Vineyard Primary Care
North East, PA 16428 - Phone
- (814) 877-7711
- Fax
- (814) 877-7715
- NPI assigned
- Jul 14, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA051409 | PA | Primary |
Addresses
Primary practice location
2060 N Pearl St
Vineyard Primary Care
North East, PA 16428
Mailing address
3699 Dogleg TRL
Erie, PA 16510-5965
Phone (814) 572-5866
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1540501 | Other | PA | BLUE SHIELD |
| 02635463 | Other | NY | NY MEDICAL ASSISTANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA051409 | PA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526515200000",
"number": "1881693661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3699 DOGLEG TRL",
"city": "ERIE",
"state": "PA",
"postal_code": "165105965",
"telephone_number": "814-572-5866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2060 N PEARL ST",
"address_2": "VINEYARD PRIMARY CARE",
"city": "NORTH EAST",
"state": "PA",
"postal_code": "16428",
"telephone_number": "814-877-7711",
"fax_number": "814-877-7715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAJEWSKI",
"first_name": "JENNIFER",
"middle_name": "DIANE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-14",
"last_updated": "2018-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA051409",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "1540501",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NY MEDICAL ASSISTANCE",
"identifier": "02635463",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.