Look up the most recent NPI and PECOS records

Jennifer Tobin

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

PECOS Enrollment

Based on the most recent information from CMS, provider Jennifer Tobin is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1508947755
Provider Type
Individual
Full Name
Tobin, Jennifer
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
10/17/2006
Last Updated
12/22/2020

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-7641

Unlisted Fax

Mailing Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-7641

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA165082 Oregon
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA10004894 Washington
Code 363AS0400X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA165082 Oregon

Provider Identifiers

ID	Description	Issuer
ID 500664202	Description Medicaid	Issuer Unlisted Oregon

Jennifer Tobin

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Gorski, Kirsten

Rowden, Daniel

Myers, Jeffrey

Brooks, Lindsay

Locicero, Stephanie

Taylor, Anne Miriam

Schulzetenberg, Briana

Cox, Ashley J

Aby-Daniel, Diana

Merz, Stacey Marie