Individual provider Active NPI

Jessica Cerasoli, PA-C

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1295100493
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA058021 Issued in PA
Practice address
219 N Broad St
Philadelphia, PA 19107-1519
Phone
(215) 762-6620
NPI assigned
Dec 14, 2015
Last updated
Jun 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C5-0001284 DE
Medical Physician Assistant 363AM0700X MA058021 PA Primary

Addresses

Primary practice location

219 N Broad St
Philadelphia, PA 19107-1519

Mailing address

169 Greenwood Ave
Apt. B5
Jenkintown, PA 19046-2626
Phone (724) 561-3313

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jessica.cerasoli.1@16196.direct.athenahealth.com Direct Trinity Health Mid-Atlantic Medical Group

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
I20190801000194 PA Practitioner - Physician Assistant 5496091936 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2301 S Broad St
Philadelphia, PA 19148-3542

3501 Masons Mill Rd
Suite 503
Huntingdon Valley, PA 19006-3517
Phone (215) 938-7730

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C5-0001284DEMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Jan 21, 2024 Accepting new patients
Methodist Associates in Healthcare, Inc. CurrentSince Oct 13, 2025 Accepting new patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Jan 21, 2024 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Oct 13, 2025 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

1501 Lansdowne Ave
Ste 210
Darby, PA 19023
Phone (610) 534-6142

1503 Lansdowne Ave
Ste 3001
Darby, PA 19023
Phone (610) 586-4100

1503 Lansdowne Ave
Ste 3003
Darby, PA 19023
Phone (610) 586-4100

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1295100493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 GREENWOOD AVE",
            "address_2": "APT. B5",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462626",
            "telephone_number": "724-561-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071519",
            "telephone_number": "215-762-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERASOLI",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-14",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DE",
            "license": "C5-0001284",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA058021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.cerasoli.1@16196.direct.athenahealth.com",
            "affiliation": "Y",
            "endpointDescription": "Mercy Management of Southeastern Pennsylvania Direct Email Address",
            "affiliationName": "Trinity Health Mid-Atlantic Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1501 Lansdowne Ave Ste 210",
            "city": "Darby",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190231333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.