JESSICA ANNE HENDRICKS – Nurse Practitioner, NPI 1689278087

JESSICA ANNE HENDRICKS is a healthcare provider. based in Los angeles, California. specializing in NURSE PRACTITIONER. They hold a License No. 95048514 (CA). The NPI Number for JESSICA ANNE HENDRICKS is 1689278087

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA ANNE HENDRICKS
NPI
1689278087
Phone
(310) 820-8084
Address
12304 SANTA MONICA BLVD STE 116
Enumeration Date
25 November 2020
Last Update Date
1 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3102024745
Graduation Year
2020 (6 years ago)
PAC ID
6901268556
Group Practice PAC ID
0244378677
Professional Enrollment ID
I20230814001701
Address ID
CA902322713CU3828XTERX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:5State licenses:2Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for JESSICA ANNE HENDRICKS

  • 12304 SANTA MONICA BLVD STE 116

    LOS ANGELES, CA 900252586

    Phone: (310) 820-8084

    Type: Mailing

  • 5767 W CENTURY BLVD STE 400

    LOS ANGELES, CA 900455631

    Phone: (310) 301-8707

    Type: Mailing

  • 15503 VENTURA BLVD STE 350

    ENCINO, CA 914363114

    Phone: (310) 820-8084

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230814001701INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes1515$0
99214Established patient office or other outpatient visit, 30-39 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 90025)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0244378677View full group profile
NameSpecialtyState
Emergency MedicineCA
Nurse PractitionerCA
General Practice, Preventive Medicine, Sports MedicineCA
-CA
Nurse PractitionerCA
Emergency MedicineCA
Emergency MedicineOK
-CA
Emergency MedicineCA
-PA

Reviews

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Frequently asked questions

Can I use this page to confirm JESSICA ANNE HENDRICKS's NPI?
Yes. JESSICA ANNE HENDRICKS is listed with NPI 1689278087 in the public NPI dataset.
Can I rely on JESSICA ANNE HENDRICKS being an active provider?
As of the registry snapshot, JESSICA ANNE HENDRICKS is marked active.
What is JESSICA ANNE HENDRICKS's specialty?
The listing groups JESSICA ANNE HENDRICKS with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does JESSICA ANNE HENDRICKS list a practice location?
Patients near Los Angeles, California may find JESSICA ANNE HENDRICKS in results; validate coverage separately.
Why does JESSICA ANNE HENDRICKS have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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