Individual provider Active NPI

Monika Jelic, NP

  • Pediatric Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1265492136
Registry record updated Oct 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP009728 Issued in PA
Practice address
216 W Somerset St
Philadelphia, PA 19133-3534
Phone
(267) 765-2272
Fax
(215) 426-5123
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X SP009728 PA Primary

Addresses

Primary practice location

216 W Somerset St
Philadelphia, PA 19133-3534

Mailing address

260 S Broad St
Philadelphia, PA 19102-5021
Phone (215) 985-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226561MAMDFamily Medicine Physician
SP009728PAMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: monikajelic@nncc.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381968000000",
    "number": "1265492136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191025021",
            "telephone_number": "215-985-2500",
            "fax_number": "267-765-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 W SOMERSET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191333534",
            "telephone_number": "267-765-2272",
            "fax_number": "215-426-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELIC",
        "first_name": "MONIKA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2013-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP009728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.