Jennifer L Ensminger, MD | |
6283 Clark Rd, Suite #10, Paradise, CA 95969-4100 | |
(530) 877-2020 | |
(530) 877-4641 |
Full Name | Jennifer L Ensminger |
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Gender | Female |
Speciality | Ophthalmology |
Location | 6283 Clark Rd, Paradise, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184600108 | NPI | - | NPPES |
107643400 | Medicaid | MN | |
P00448265 | Other | MN | MEDICARE RAILROAD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | 47903 (Minnesota) | Secondary |
207W00000X | Ophthalmology | A102699 (California) | Primary |
Entity Name | Providence Medical Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346 |
Mailing Address | Practice Location Address |
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Jennifer L Ensminger, MD 6283 Clark Rd, Suite 10, Paradise, CA 95969-4100 Ph: (530) 877-2020 | Jennifer L Ensminger, MD 6283 Clark Rd, Suite #10, Paradise, CA 95969-4100 Ph: (530) 877-2020 |
Dr. Jerome Wh Niswonger, MD Ophthalmology Medicare: Medicare Enrolled Practice Location: 6283 Clark Rd, #10, Paradise, CA 95969 Phone: 530-877-2020 Fax: 530-877-4641 | |
Dr. David Jeffery Gajda, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 5889 Clark Road, Paradise, CA 95969 Phone: 530-877-2020 Fax: 530-877-4641 | |
Robert B Reeve, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 6009 Pentz Rd, Paradise, CA 95969 Phone: 530-877-6583 Fax: 530-877-6590 | |
Dr. George Jamil Boutros, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 7068 Skyway, Paradise, CA 95969 Phone: 805-815-7920 |