Individual provider Active NPI

Jessica Perfetto, MD

  • Pediatric Rheumatology Physician
  • Philadephia, PA
National Provider Identifier
1235622317
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
309752 Issued in NY
Practice address
3401 Civic Center Boulevard
9NW, Room 55
Philadephia, PA 19104-4399
Phone
(215) 590-1220
NPI assigned
Jun 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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 MT215150 PA
Pediatric Rheumatology Physician 2080P0216X 309752 NY Primary

Addresses

Primary practice location

3401 Civic Center Boulevard
9NW, Room 55
Philadephia, PA 19104-4399

Mailing address

3401 Civic Center Boulevard
9NW, Room 55
Philadephia, PA 19104-4399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240516000672 NY Practitioner - Pediatric Medicine 2769823137 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309752NYMDRegistered Nurse
MT215150PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MMC Pediatrics Faculty Practice Pediatrics CurrentSince Jul 10, 2024 Accepting new patients
New York University CurrentSince May 1, 2024 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Jul 10, 2024 Accepting new patients
New York University Pediatrics CurrentSince May 1, 2024 Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

160 E 32nd St
Fl 3
New York, NY 10016
Phone (212) 263-5940

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: jessica.perfetto.p1@direct.mmc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1235622317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BOULEVARD",
            "address_2": "9NW, ROOM 55",
            "city": "PHILADEPHIA",
            "state": "PA",
            "postal_code": "191044399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BOULEVARD",
            "address_2": "9NW, ROOM 55",
            "city": "PHILADEPHIA",
            "state": "PA",
            "postal_code": "191044399",
            "telephone_number": "215-590-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERFETTO",
        "first_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT215150",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "NY",
            "license": "309752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadephia, PA

Sources for this page

Verify at the official NPI Registry.