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

Jennifer Villegas, PAC

Individual provider Physician Assistant · NPI 1114705571

Jennifer Villegas, PAC is a Physician Assistant in Lawrenceville, Georgia. Qualified in 2024, 2 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2023
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

2200 Medical Center Blvd Ste 320
Lawrenceville, GA 30046-7767
Phone: (470) 325-1160
Fax: (678) 701-9860
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 13012 (GA)

Record details

NPI number1114705571
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedSeptember 18, 2023
Last updated in NPPESApril 13, 2025
Certification dateApril 13, 2025
Mailing address2200 Medical Center Blvd Ste 320, Lawrenceville, GA 30046-7767

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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