Mallory Rose Jenson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085004404 Issued in IL

Practice address

6141 N Cicero Ave
Chicago, IL 60646-4303

Phone

(224) 364-2273

Fax

(847) 663-8290

NPI assigned

Sep 21, 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

Other names 1

• Mallory Rose Geschke Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment Care Compare group
• Midwest Orthopaedics at Rush, LLC

  • Orthopaedic Surgery Physician
  • Chicago, IL
  • NPI 1811942451
  Medicare reassignment NPD
• Swedish Covenant Management Services, Inc.

  dba Swedish Covenant Medical Group

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1760432348
  Medicare reassignment
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Midwest Orthopaedics at Rush LLC

  • Durable Medical Equipment & Medical Supplies
  • Orland Park, IL
  • NPI 1134871908
  NPD
• Swedish Covenant Management Services, Inc

  dba Swedish Emergency Medicine

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1962049551

  Physician Assistant

  NPD
• Swedish Covenant Management Services, Inc.

  dba Comprehensive Wellness Care

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1407002108
  NPD

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

• Endeavor Health Clinical Operations

  dba Endeavor Health Evanston Hospital

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1881945558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6141 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464303",
            "telephone_number": "224-364-2273",
            "fax_number": "847-663-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6141 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464303",
            "telephone_number": "224-364-2273",
            "fax_number": "847-663-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSON",
        "first_name": "MALLORY",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-21",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004404",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.004404",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS STATE LICENSE NUMBER",
            "identifier": "085.004404",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS CONTROLLED SUBSTANCE LICENSE",
            "identifier": "385003174",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "GESCHKE",
            "middle_name": "ROSE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ross Jensen, M.S.
• Sarah W Jensen, PT
• Stephen Jensik, M.D.
• Jamie Jenskovec
• Heather Jensky
• Anna Jent, DNAP
• Nathan Jent, PA-C
• Richard Allen Jentzen, LCSW
• Julia E Jenvey
• Alexander Jeon, DO

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.