JENNA LEE DUBRUIEL (PA) – Physician Assistant, NPI 1114281748

JENNA LEE DUBRUIEL (PA) is a healthcare provider. based in Dyer, Tennessee. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 2166 (TN). The NPI Number for JENNA LEE DUBRUIEL (PA) is 1114281748

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
JENNA LEE DUBRUIEL (PA)
NPI
1114281748
Phone
(731) 692-2853
Address
1123 N MAIN ST
Enumeration Date
28 June 2012
Last Update Date
11 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7318852410
Graduation Year
2012 (14 years ago)
PAC ID
5294982526
Group Practice PAC ID
0042307852
Professional Enrollment ID
I20120821001098
Address ID
TN382615403UN1201XSTXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

3,118 PHYSICIAN ASSISTANT in TN

Provider Addresses for JENNA LEE DUBRUIEL (PA)

  • 1123 N MAIN ST

    DYER, TN 383301019

    Phone: (731) 692-2853

    Fax: (731) 692-2367

    Type: Location

  • 1431 CENTERPOINT BLVD

    SUITE 100

    KNOXVILLE, TN 379321984

    Phone:

    Type: Mailing

  • 1201 BISHOP ST

    UNION CITY, TN 382615403

    Phone: (731) 885-2410

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $295.

Total Amount is formed as General ($295) + Research ($0) + Ownership ($0) = $295.

Last reported payment date: 2024-05-10 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($82).

Total Amount

$295

General + Research + Ownership

Payments

16

Total payment records

General Amount

$295

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-10

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2012-08-21

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
I20120821001098IPhysician AssistantTNTBD

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 minutes216102$0
36415Insertion of needle into vein for collection of blood sample145100$0
99214Established patient office or other outpatient visit, 30-39 minutes9773$0
J1100Injection, dexamethasone sodium phosphate, 1 mg9626$0
J0696Injection, ceftriaxone sodium, per 250 mg8119$0
View full utilization report →

Insurance plans in this area (ZIP 38330)

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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: 0042307852View full group profile
NameSpecialtyState
-KY
Family Practice, Geriatric MedicineKY
Internal MedicineNY
Emergency Medicine, Internal MedicineMS
-MO
Family Practice, Hospitalist, Family PracticeFL
Internal MedicineTN
Internal MedicineSC
Internal MedicineNC
-TN

Reviews

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Frequently asked questions

Is JENNA LEE DUBRUIEL (PA) listed with a National Provider Identifier?
Yes — JENNA LEE DUBRUIEL (PA) has NPI 1114281748 on file in the registry.
Is there an active status for JENNA LEE DUBRUIEL (PA)?
For scheduling context, JENNA LEE DUBRUIEL (PA) is shown as active in the registry.
What clinical focus is listed for JENNA LEE DUBRUIEL (PA)?
At a glance, JENNA LEE DUBRUIEL (PA) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
Is JENNA LEE DUBRUIEL (PA) located near Dyer?
JENNA LEE DUBRUIEL (PA) currently maps to Dyer, Tennessee in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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