Siji Mary John, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

011428 Issued in NY

Practice address

501 S 54TH St
Mercy Gastroenterology Associates
Philadelphia, PA 19143-1900

Phone

(215) 748-9833

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Aria Health Physician Services

  • Family Medicine Physician
  • Richboro, PA
  • NPI 1750949806
  Medicare reassignment Care Compare group
• Aria Health Physicain Services

  • Critical Care Medicine (Anesthesiology) Physician
  • Philadelphia, PA
  • NPI 1649789587
  NPD
• Aria Health Physician Services

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053181297
  NPD

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

• Jefferson Health - Northeast

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1801963343
  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1083733869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 -11 251 ST",
            "address_2": "85-11",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114262127",
            "telephone_number": "718-776-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 54TH ST",
            "address_2": "MERCY GASTROENTEROLOGY ASSOCIATES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431900",
            "telephone_number": "215-748-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "SIJI",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011428",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054486",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliet John, FNP
• Miriam John
• Reeba John
• Salma John, FNP, CRNP # F0325038
• Sharoon John
• Tara Anne John, MD
• Janae Johns
• Angelica Johnsen, MD
• Joyce Johnsen, CCC-SLP
• Johnson Adult Center

• Physician Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.