NPIMap

Individual provider Active NPI

Jessica Irene Rodini, PA-C

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1225567969
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
3509 N Broad St
Philadelphia, PA 19140-4105
Phone
(215) 707-3375
Fax
(215) 707-4758
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

3509 N Broad St
Philadelphia, PA 19140-4105

Mailing address

3500 N. Broad Street
Room 001a
Philadelphia, PA 19140-4106
Phone (215) 926-9022

Other practice location 1

501 S 54th St Ste 227
Philadelphia, PA 19143-1900
Phone (215) 748-9802

Other practice location 2

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-3834

Other practice location 3

1501 Lansdowne Ave Fl Mob1
Darby, PA 19023-1333
Phone (610) 237-4104

Other names 1

  • Jessica Irene Panieczko Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jessica.rodini.1@16196.direct.athenahealth.com Direct Mercy Management of Southeastern Pennsylvania

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190403000402 PA Practitioner - Physician Assistant 8123369063 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103

Hospital & facility affiliations

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan, Inc CurrentSince Feb 6, 2019 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Jul 11, 2022 Accepting new patients
Einstein Practice Plan Inc CurrentSince Feb 6, 2019 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Jul 11, 2022 Accepting new patients
Fornance Physician Services, Inc. Past Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients

Locations

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

2705 DeKalb Pike
Norristown, PA 19401
Phone (215) 214-3269

3509 N Broad St
Philadelphia, PA 19140
Phone (215) 707-2433

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

3500 N Broad St
Rm 1A
Philadelphia, PA 19140
Phone (215) 707-2433

7500 Central Ave
Philadelphia, PA 19111
Phone (215) 214-4100

559 W Germantown Pike
West Norriton, PA 19403
Phone (484) 622-1000

Organizations & group practices 9

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1225567969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N. BROAD STREET",
            "address_2": "ROOM 001A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106",
            "telephone_number": "215-926-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105",
            "telephone_number": "215-707-3375",
            "fax_number": "215-707-4758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S 54th St Ste 227",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191431900",
            "country_code": "US",
            "telephone_number": "215-748-9802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-3834",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 Lansdowne Ave Fl Mob1",
            "address_purpose": "LOCATION",
            "city": "Darby",
            "state": "PA",
            "postal_code": "190231333",
            "country_code": "US",
            "telephone_number": "610-237-4104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODINI",
        "first_name": "JESSICA",
        "middle_name": "IRENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.rodini.1@16196.direct.athenahealth.com",
            "affiliation": "Y",
            "endpointDescription": "Mercy Management of Southeastern Pennsylvania Direct Email Address",
            "affiliationName": "Mercy Management of Southeastern Pennsylvania",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1501 Lansdowne Ave Fl Mob1",
            "city": "Darby",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190231333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "PANIECZKO",
            "middle_name": "IRENE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.