JESSICA TANNER (PA-C) – Physician Assistant, NPI 1124577416
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,429 PHYSICIAN ASSISTANT in VA
Provider Addresses for JESSICA TANNER (PA-C)
5716 CLEVELAND ST STE 200
VIRGINIA BEACH, VA 234621784
Phone: (757) 490-4802
Type: Location
632, 3rd Street, Kingsland, Lyndhurst, Bergen County, New Jersey, 07071, United States
LYNDHURST, NJ 070712812
Phone: (973) 809-0855
Type: Mailing
Crowne Plaza Englewood, 401, South Van Brunt Street, Englewood, Bergen County, New Jersey, 07631, United States
ENGLEWOOD, NJ 076314604
Phone: (201) 569-2770
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $53.
Total Amount is formed as General ($53) + Research ($0) + Ownership ($0) = $53.
Last reported payment date: 2023-11-16 • Largest payer in this snapshot: Fidia Pharma USA Inc. ($34).
Total Amount
$53
General + Research + Ownership
Payments
3
Total payment records
General Amount
$53
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Fidia Pharma USA Inc. | $34 |
| DePuy Synthes Sales Inc. | $19 |
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: 2019-08-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20161229000011 | I | Physician Assistant | NJ | TBD |
| I20190826003764 | I | Physician Assistant | VA | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 6,230 | 328 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 676 | 341 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 561 | 432 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 468 | 361 | $0 |
| 73564 | X-ray of knee, 4 or more views | 360 | 253 | $0 |
Insurance plans in this area (ZIP 23462)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | VA | |
| Physical Therapist In Private Practice | VA | |
| Physician Assistant | MD | |
| Physician Assistant | VA | |
| - | VA | |
| Orthopedic Surgery, Sports Medicine | VA | |
| Orthopedic Surgery | VA | |
| - | MD | |
| - | MD | |
| Physical Therapist In Private Practice | TX |
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