Individual provider Active NPI

Rebecca Prosser

  • Women's Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1043743966
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
SP017377 Issued in PA
Practice address
833 Chestnut Street
1St Floor
Philadelphia, PA 19107-4420
Phone
(215) 955-5000
NPI assigned
Apr 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X MW010438 PA
Women's Health Nurse Practitioner 363LW0102X SP017377 PA Primary

Addresses

Primary practice location

833 Chestnut Street
1St Floor
Philadelphia, PA 19107-4420

Mailing address

833 Chestnut Street
1St Floor
Philadelphia, PA 19107-4420
Phone (215) 955-5000

Other practice location 1

1233 Locust St Ste 401
Philadelphia, PA 19107-5459
Phone (215) 955-8577

Other identifiers 1

IdentifierTypeStateIssuer
103300667MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170703000024 PA Practitioner - Nurse Practitioner 9335418532 Reassigns benefits to 1 organization
I20191223001207 PA Practitioner - Certified Nurse Midwife (CNM) 9335418532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

833 Chestnut St
Philadelphia, PA 19107-4420
Phone (215) 955-5000

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
MW010438PAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince May 3, 2017 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

3 Crescent Dr
Ste 100
Philadelphia, PA 19112
Phone (215) 503-3300

833 Chestnut St
Fl 1
Philadelphia, PA 19107
Phone (215) 955-1085

1302 Wolf St
Philadelphia, PA 19148
Phone (215) 952-5170

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1043743966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT STREET",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074420",
            "telephone_number": "215-955-5000",
            "fax_number": "215-923-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT STREET",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074420",
            "telephone_number": "215-955-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1233 Locust St Ste 401",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075459",
            "country_code": "US",
            "telephone_number": "215-955-8577",
            "fax_number": "215-568-6414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROSSER",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-07",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW010438",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "PA",
            "license": "SP017377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103300667",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.