Individual provider Active NPI

Jasmine Ross

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1124896436
Registry record updated May 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP028874 Issued in PA
Practice address
3500 Civic Center Blvd
Philadelphia, PA 19104-4395
Phone
(215) 590-1000
NPI assigned
Dec 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP028874 PA Primary
Pediatric Nurse Practitioner 363LP0200X SP028874 PA

Addresses

Primary practice location

3500 Civic Center Blvd
Philadelphia, PA 19104-4395

Mailing address

7908 Tabor Ave
Philadelphia, PA 19111-2655
Phone (215) 589-5658

Other practice location 1

100 Deerfield Ln Ste 110
Malvern, PA 19355-2100
Phone (610) 334-8341

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241212001198 PA Practitioner - Nurse Practitioner 7618403775 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP028874PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Childen'S Health Care Associates Inc. CurrentSince Oct 25, 2024 Accepting new patients
Advocare, LLC CurrentSince Feb 3, 2025 Accepting new patients
Advocare , LLC CurrentSince Feb 3, 2025 Accepting new patients
Childrens Health Care Associates, Inc Current Accepting new patients
Childrens Health Care Associates, Inc CurrentSince Oct 25, 2024 Accepting new patients
Advocare, LLC Past Accepting new patients
Childrens Health Care Associates of New Jersey PC Past Accepting new patients

Locations

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

1100 Horizon Cir
Ste 101
Chalfont, PA 18914
Phone (215) 394-0400

550 S Goddard Blvd
King of Prussia, PA 19406
Phone (610) 337-3232

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

2929 Arch St
Fl 12
Philadelphia, PA 19104

3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748649600000",
    "number": "1124896436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7908 TABOR AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112655",
            "telephone_number": "215-589-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044395",
            "telephone_number": "215-590-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Deerfield Ln Ste 110",
            "address_purpose": "LOCATION",
            "city": "Malvern",
            "state": "PA",
            "postal_code": "193552100",
            "country_code": "US",
            "telephone_number": "610-334-8341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JASMINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-15",
        "last_updated": "2025-05-31",
        "certification_date": "2025-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP028874",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP028874",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.