Individual provider Active NPI

Jenna Mahoney, DO

  • Cardiovascular Disease Physician
  • Hershey, PA
National Provider Identifier
1053060335
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
OT024151 Issued in PA
Practice address
500 University Dr
Hershey, PA 17033-2360
Phone
(717) 531-8521
NPI assigned
Mar 22, 2022
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Cardiovascular Disease Physician 207RC0000X OT024151 PA Primary

Addresses

Primary practice location

500 University Dr
Hershey, PA 17033-2360

Mailing address

500 University Dr
Hershey, PA 17033-2360

Other practice location 1

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220607002629 DE Order and Referring Only - Cardiovascular Disease (Cardiology)Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2860870664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1053060335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-8521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4755 Ogletown Stanton Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197182200",
            "country_code": "US",
            "telephone_number": "302-733-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "JENNA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OT024151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.