Individual provider Active NPI

Jeanne Llenado, D.O.

  • Urology Physician
  • Philadelphia, PA
National Provider Identifier
1306862602
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
OS-011077-L Issued in PA
Practice address
3 Crescent Dr FL 2
Philadelphia, PA 19112-1016
Phone
(215) 503-7124
Fax
(215) 503-3191
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OS-011077-L PA
Urology Physician 208800000X 25MB06433200 NJ
Urology Physician 208800000X OS-011077-L PA Primary

Addresses

Primary practice location

3 Crescent Dr FL 2
Philadelphia, PA 19112-1016

Mailing address

3 Crescent Dr FL 2
Philadelphia, PA 19112-1016
Phone (215) 503-7124

Other practice location 1

457 Haddonfield Rd Ste 110
Cherry Hill, NJ 08002-2223
Phone (856) 406-4094

Other practice location 2

811 Sunset Rd Ste 104
Burlington Township, NJ 08016-3645
Phone (609) 239-8690

Other identifiers 2

IdentifierTypeStateIssuer
001853497MedicaidPA
8536201MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050215000743 PA Practitioner - Urology 3971555285 Reassigns benefits to 1 organization
I20160805001114 NJ Practitioner - Urology 3971555285 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Rowan University School of Osteopathic Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

3 Crescent Dr
Suite 100
Philadelphia, PA 19112-1016
Phone (215) 955-2392

511 Kings Hwy N
Cherry Hill, NJ 08034-1503
Phone (856) 667-1654

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB06433200NJMDUrology Physician
OS-011077-LPAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians of New Jersey, P.C. CurrentSince Aug 1, 2016 Accepting new patients
Jefferson University Physicians Surgery CurrentSince Jul 1, 2001 Accepting new patients
Kennedy Medical Group Practice P.C. CurrentSince Sep 6, 2022 Accepting new patients
Kennedy Medical Group Practice, P.C. Current Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

811 Sunset Rd
Ste 104105
Burlington, NJ 08016

811 Sunset Rd
Burlington, NJ 08016
Phone (609) 387-9242

811 Sunset Rd
Ste 104
Burlington Township, NJ 08016
Phone (609) 239-8690

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

2211 Chapel Ave W
Ste 301
Cherry Hill, NJ 08002
Phone (844) 309-7708

511 Kings Hwy N
Cherry Hill, NJ 08034
Phone (609) 667-1654

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

443 Laurel Oak Rd
Ste 130
Voorhees, NJ 08043
Phone (856) 741-0122

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

833 Chestnut St
Ste 703
Philadelphia, PA 19107
Phone (215) 955-1000

3 Crescent Dr
Fl 2
Philadelphia, PA 19112
Phone (215) 503-7096

3 Crescent Dr
Ste 100
Philadelphia, PA 19112
Phone (215) 503-3300

Organizations & group practices 6

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 2

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1306862602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CRESCENT DR FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191121016",
            "telephone_number": "215-503-7124",
            "fax_number": "215-503-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CRESCENT DR FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191121016",
            "telephone_number": "215-503-7124",
            "fax_number": "215-503-3191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "457 Haddonfield Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080022223",
            "country_code": "US",
            "telephone_number": "856-406-4094",
            "fax_number": "856-406-4570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "811 Sunset Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Burlington Township",
            "state": "NJ",
            "postal_code": "080163645",
            "country_code": "US",
            "telephone_number": "609-239-8690",
            "fax_number": "609-239-8696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LLENADO",
        "first_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "OS-011077-L",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MB06433200",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "OS-011077-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001853497",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8536201",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.