Individual provider Active NPI

Jessica Schiffman Gaulton, MD

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1083906317
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
262370 Issued in MA
Practice address
3401 Civic Center Blvd
Division of Neonatology
Philadelphia, PA 19104-4319
Phone
(215) 590-4393
NPI assigned
May 4, 2011
Last updated
Jun 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 262370 MA Primary
Neonatal-Perinatal Medicine Physician 2080N0001X MT210470 PA

Addresses

Primary practice location

3401 Civic Center Blvd
Division of Neonatology
Philadelphia, PA 19104-4319

Mailing address

1923 Webster St
Philadelphia, PA 19146-1827
Phone (404) 803-3176

Other names 1

  • Jessica Kerr Schiffman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20221215000328 MA Practitioner - Pediatric Medicine 7315162906 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT210470PAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Auburn Professional Services Inc CurrentSince Oct 3, 2022 Accepting new patients
Familywell PLLC CurrentSince Jun 1, 2022 Accepting new patients
Mt Auburn Professional Services CurrentSince Oct 3, 2022 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

330 Mount Auburn St
Cambridge, MA 02138
Phone (617) 499-5054

57 Bedford St
Ste 130
Lexington, MA 02420
Phone (781) 484-7500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/86/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jgaulton255245@direct.bilh.masshiway.net

Organizations & group practices 4

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": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1083906317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 WEBSTER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461827",
            "telephone_number": "404-803-3176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF NEONATOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAULTON",
        "first_name": "JESSICA",
        "middle_name": "SCHIFFMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "262370",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "PA",
            "license": "MT210470",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SCHIFFMAN",
            "middle_name": "KERR",
            "credential": "MD, MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.