Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jennifer Nicole Tisdale, PA-C

Individual provider Physician Assistant · NPI 1154814697

Jennifer Nicole Tisdale, PA-C is a Physician Assistant in Norfolk, Virginia. Graduated from Eastern Virginia Medical School in 2018, 8 years ago. Practices with Sentara Medical Group, a 1,403-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Virginia.

Years since qualifying
8
Trained at
Eastern Virginia Medical School
Licensed in
VA
In the registry since
2018
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

7401 Granby St
Norfolk, VA 23505-3406
Phone: (757) 388-9925
Fax: (757) 965-8519
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7401 Granby St, Norfolk, VA 23505-3406 — (757) 388-9925

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 0110006241 (VA)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1154814697
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 9, 2018
Last updated in NPPESOctober 3, 2024
Certification dateOctober 3, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolEASTERN VIRGINIA MEDICAL SCHOOL
Graduated 2018 (8 years in practice)
Group practice Sentara Medical Group — 1403 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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