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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

JALYSSA RAE BENNETT PA
NPI 1952200685
Physician Assistant in Fort Wayne, IN

Active since October 31, 2026
2200 RANDALLIA DR APT 3, FORT WAYNE, IN 46805(406) 241-6467 Get Directions Write a Review

NPPES record added: October 31, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Jalyssa Rae Bennett Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JALYSSA RAE BENNETT PA (NPI 1952200685) is an individual physician assistant in Fort Wayne, Indiana and active in the NPI registry since October 2026.

NPPES Registry Identity

NPI1952200685
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameJALYSSA RAE BENNETTCredential: PA
Location Address2200 RANDALLIA DR APT 3Fort Wayne, IN 46805-4638
Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701 · (406) 241-6467
Phone(406) 241-6467
Sole ProprietorNo
Enumeration DateOctober 31, 2026
NPPES CertifiedOctober 31, 2026
✔ NPI 1952200685 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2200 RANDALLIA DR APT 3, Fort Wayne, IN 46805
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jalyssa Bennett's NPI number?

The NPI number for Jalyssa Bennett is 1952200685. It was assigned to this individual provider in the NPPES registry on October 31, 2026.

Where is Jalyssa Bennett located?

Jalyssa Bennett practices at 2200 Randallia Dr Apt 3, Fort Wayne, IN 46805. The listed phone number is (406) 241-6467.

What is Jalyssa Bennett's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Jalyssa Bennett was last updated on October 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.