Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jenna Wagenblatt

Individual provider Physician Assistant · NPI 1578286936

Jenna Wagenblatt is a Physician Assistant in Liverpool, New York. Qualified in 2022, 4 years ago. Practices with St Josephs Medical PC, a 385-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
4
In the registry since
2022
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Practice location Address checks out

5100 W Taft Rd # L
Liverpool, NY 13088-3807
Phone: (315) 452-2828
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1578286936
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 21, 2022
Last updated in NPPESFebruary 4, 2023
Certification dateFebruary 4, 2023
Mailing address5100 W Taft Rd # L, Liverpool, NY 13088-3807

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice St Josephs Medical Pc — 385 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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