Individual provider Active NPI

Jennifer Sebastian, PA-C

  • Medical Physician Assistant
  • Costa Mesa, CA
National Provider Identifier
1942627880
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
51365 Issued in CA
Practice address
3151 Airway Ave Ste G1
Costa Mesa, CA 92626-4624
Phone
(714) 545-5550
Fax
(714) 708-2588
NPI assigned
Mar 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 51365 CA Primary

Addresses

Primary practice location

3151 Airway Ave Ste G1
Costa Mesa, CA 92626-4624

Mailing address

3151 Airway Ave Ste G1
Costa Mesa, CA 92626-4624
Phone (714) 545-5550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180502001686 CA Practitioner - Physician Assistant 3173887965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Neuropsychiatric Specialists IncGroup PAC ID 3375796170, 70 clinicians

Practice addresses (Care Compare)

3151 Airway Ave
Suite G1
Costa Mesa, CA 92626-4624
Phone (714) 545-5550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51365CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Market Pharmacy LLC PastSince Sep 5, 2023 Accepting new patients
Hoag Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jen@pnsi-ca.direct.office.nextgen.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1942627880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE G1",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264624",
            "telephone_number": "714-545-5550",
            "fax_number": "714-708-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE G1",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264624",
            "telephone_number": "714-545-5550",
            "fax_number": "714-708-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBASTIAN",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "51365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.