Individual provider Active NPI

Jessica Deffler, M.D.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1063945400
Registry record updated Aug 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD469188 Issued in PA
Practice address
833 Chestnut St Ste 301
Suite 301
Philadelphia, PA 19107-4414
Phone
(215) 955-7190
Fax
(215) 955-8600
NPI assigned
Apr 4, 2017
Last updated
Aug 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2020

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
Family Medicine Physician 207Q00000X MD469188 PA Primary

Addresses

Primary practice location

833 Chestnut St Ste 301
Suite 301
Philadelphia, PA 19107-4414

Mailing address

833 Chestnut St Ste 301
Suite 301
Philadelphia, PA 19107-4414
Phone (215) 955-2363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200928000060 PA Practitioner - Family Practice 4082982533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wake Forest University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

833 Chestnut St
East 3Rd FLR Suite 301
Philadelphia, PA 19107-5102
Phone (215) 955-7190

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Family Medicine CurrentSince Aug 15, 2020 Accepting new patients

Locations

833 Chestnut St
Frnt 3
Philadelphia, PA 19107
Phone (215) 955-5800

833 Chestnut St
Ste 301
Philadelphia, PA 19107
Phone (215) 955-2363

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

Interoperability endpoints

  • Direct secure messaging: jessica.deffler.1@27241.direct.athenahealth.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597536000000",
    "number": "1063945400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 301",
            "address_2": "SUITE 301",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414",
            "telephone_number": "215-955-2363",
            "fax_number": "215-955-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 301",
            "address_2": "SUITE 301",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414",
            "telephone_number": "215-955-7190",
            "fax_number": "215-955-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFFLER",
        "first_name": "JESSICA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2020-08-16",
        "certification_date": "2020-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD469188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.