JENNIFER RIDENOURE (P.A.C) – Medical Physician Assistant, NPI 1912012816
Medical Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for JENNIFER RIDENOURE (P.A.C)
2936 CAMBRIDGE LN
HOLLYWOOD, FL 330263748
Phone: (954) 704-0108
Type: Mailing
1330, Riverland Road, Riverland, Fort Lauderdale, Broward County, Florida, 33312, United States
FORT LAUDERDALE, FL 333122961
Phone: (954) 321-9826
Fax: (954) 321-9660
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $49.
Total Amount is formed as General ($49) + Research ($0) + Ownership ($0) = $49.
Last reported payment date: 2024-05-06 • Largest payer in this snapshot: Vanda Pharmaceuticals Inc. ($30).
Total Amount
$49
General + Research + Ownership
Payments
2
Total payment records
General Amount
$49
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Vanda Pharmaceuticals Inc. | $30 |
| PFIZER 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: 2005-11-17
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051117000215 | I | Physician Assistant | FL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33026)
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