Jenniffer Sue Ferguson, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9103323 Issued in FL

Practice address

601 E Dixie Ave
Plaza 901
Leesburg, FL 34748-5998

Phone

(352) 728-2404

Fax

(352) 787-7401

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Jenniffer Sue Elwell Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake ENT and FPS, PAGroup PAC ID 1759380447, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Waterman Hospital, Tavares, FL, CCN 100057

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Lake ENT & FPS, PA

  • Specialist
  • Leesburg, FL
  • NPI 1629091996
  Medicare reassignment Care Compare group

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

• Florida Hospital Waterman Inc

  • General Acute Care Hospital
  • Tavares, FL
  • NPI 1821019571
  Care Compare affiliation

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1922029560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E DIXIE AVE",
            "address_2": "PLAZA 901",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485998",
            "telephone_number": "352-728-2404",
            "fax_number": "352-787-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E DIXIE AVE",
            "address_2": "PLAZA 901",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485998",
            "telephone_number": "352-728-2404",
            "fax_number": "352-787-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "JENNIFFER",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292263100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFFER",
            "last_name": "ELWELL",
            "middle_name": "SUE",
            "prefix": "MS.",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; 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.