JENNY LE – Medical Physician Assistant, NPI 1902630007

JENNY LE is a healthcare provider. based in Jacksonville, Florida. specializing in PHYSICIAN ASSISTANT. The NPI Number for JENNY LE is 1902630007

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
JENNY LE
NPI
1902630007
Phone
Not provided
Address
6675 CORPORATE CENTER PKWY STE 115
Enumeration Date
29 August 2024
Last Update Date
29 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3866283376
Graduation Year
2024 (2 years ago)
PAC ID
0345779252
Group Practice PAC ID
6103240833
Professional Enrollment ID
I20250122001802
Address ID
FL327517258MA2300XPKWY401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience27
Completeness75
Years active:1State licenses:0Digital endpointsOther names

9,232 PHYSICIAN ASSISTANT in FL

Provider Addresses for JENNY LE

  • 6675 CORPORATE CENTER PKWY STE 115

    JACKSONVILLE, FL 322168088

    Phone:

    Mailing address matches the actual address.

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: 2025-01-22

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
I20250122001802IPhysician AssistantFLTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32216)

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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: 6103240833View full group profile
NameSpecialtyState
Nurse PractitionerFL
Physician AssistantFL
D E R M A T O L O G YFL
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

How is JENNY LE identified in CMS data?
CMS-hosted NPPES data lists JENNY LE with NPI 1902630007.
Is JENNY LE listed as active for patients and plans?
The listing shows JENNY LE as active in the NPI system.
What is JENNY LE's primary classification?
Medical Physician Assistant is the headline specialty for JENNY LE here. Clinical services aligned with this taxonomy classification.
Where should I expect JENNY LE on a map?
Expect Jacksonville, Florida as a primary anchor for JENNY LE unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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