JENNIFER J.R. LOOMIS (AA-C) – Anesthesiologist Assistant, NPI 1104919604

JENNIFER J.R. LOOMIS (AA-C) is a healthcare provider. based in Painesville, Ohio. specializing in ANESTHESIOLOGY ASSISTANT. They hold the professional credentials AA-C. They hold a License No. 67.000123 (OH). The NPI Number for JENNIFER J.R. LOOMIS (AA-C) is 1104919604

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER J.R. LOOMIS (AA-C)
NPI
1104919604
Phone
(440) 350-0832
Address
7757 AUBURN RD STE 15
Enumeration Date
2 October 2006
Last Update Date
28 February 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4403500832
Graduation Year
2006 (20 years ago)
PAC ID
5496753113
Group Practice PAC ID
9537222138
Professional Enrollment ID
I20061113000408
Address ID
OH440944625WI36000AVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

424 ANESTHESIOLOGY ASSISTANT in OH

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Provider Addresses for JENNIFER J.R. LOOMIS (AA-C)

  • 7757 AUBURN RD STE 15

    PAINESVILLE, OH 440779604

    Phone: (440) 350-0832

    Fax: (440) 354-7420

    Type: Mailing

  • Lake County Memorial Hospital West, 36000, Euclid Avenue, Concord Mobile Home Park, Willoughby, Lake County, Ohio, 44094, United States

    WILLOUGHBY, OH 440944625

    Phone: (440) 350-0832

    Fax: (440) 354-7420

    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: 2006-11-13

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
I20061113000408IAnesthesiology AssistantOHTBD

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 44077)

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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: 9537222138View full group profile
NameSpecialtyState
Anesthesiology AssistantOH
Certified Registered Nurse Anesthetist (Crna)OH
Anesthesiology AssistantOH
-OH
Certified Registered Nurse Anesthetist (Crna)WV
Certified Registered Nurse Anesthetist (Crna)OH
-OH
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH

Reviews

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Frequently asked questions

How do I look up JENNIFER J.R. LOOMIS (AA-C) by NPI?
Use NPI 1104919604 when you need to reference JENNIFER J.R. LOOMIS (AA-C) in forms, claims, or directories.
Is JENNIFER J.R. LOOMIS (AA-C)'s NPI currently valid?
The extract we use shows JENNIFER J.R. LOOMIS (AA-C) as active.
Does JENNIFER J.R. LOOMIS (AA-C) list a primary specialty?
If you are matching referrals, note Anesthesiologist Assistant for JENNIFER J.R. LOOMIS (AA-C). Clinical services aligned with this taxonomy classification.
Where is JENNIFER J.R. LOOMIS (AA-C)'s primary listing?
We display Painesville, Ohio because that is what the record indicates for JENNIFER J.R. LOOMIS (AA-C).
What if Painesville, Ohio seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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