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

Jesse Ennis, PA-C

Individual provider Physician Assistant · NPI 1063810844

Jesse Ennis, PA-C is a Physician Assistant in Homer, Alaska. Graduated from Oregon Health Sciences University School of Medicine in 2016, 10 years ago. Practices with Goodland Regional Medical Center, a 22-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
10
Trained at
Oregon Health Sciences University School of Medicine
Licensed in
CO
In the registry since
2014
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

4201 Bartlett St
Homer, AK 99603-7015
Phone: (907) 235-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 16951 E Quincy Ave, Aurora, CO 80015-1901 — (303) 752-5480

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA.0007001 (CO)

Record details

NPI number1063810844
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedDecember 10, 2014
Last updated in NPPESApril 23, 2026
Certification dateApril 23, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Goodland Regional Medical Center — 22 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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