NPIMap

Individual provider Active NPI

Christina Jacovides

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1326467309
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD471142 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-3133
Fax
(215) 707-2915
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X MD471142 PA
Surgery Physician 208600000X MD471142 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3500 N Broad St # 1a
Philadelphia, PA 19140-4106
Phone (215) 707-2433

Other practice location 1

1015 Chestnut St
Suite 620
Philadelphia, PA 19107-4316
Phone (215) 955-6864

Other practice location 2

3737 Market St
Fl 4
Philadelphia, PA 19104-5545
Phone (215) 662-7320

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
I20210712002028 PA Practitioner - General Surgery 2769605229 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Perelman School of Med at the University of Pennsylvania, 2014
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
Phone (215) 707-3008

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD471142PAMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Sep 1, 2022 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
University of Penn-Medical Group CurrentSince Aug 1, 2021 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Sep 1, 2022 Accepting new patients
University of Penn - Medical Group CurrentSince Aug 1, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Aug 1, 2021 Accepting new patients
University of Penn - Medical Group Current Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients
Temple Faculty Practice Plan, Inc PastSince Sep 29, 2024 Accepting new patients
Temple University Hospital, Inc Past Accepting new patients

Locations

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

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

3737 Market St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-8664

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

1800 Lombard St
Ste 206
Philadelphia, PA 19146
Phone (215) 615-2222

3500 N Broad St
#1A
Philadelphia, PA 19140

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 11

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": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1326467309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD ST # 1A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106",
            "telephone_number": "215-707-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3133",
            "fax_number": "215-707-2915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Chestnut St",
            "address_2": "Suite 620",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074316",
            "country_code": "US",
            "telephone_number": "215-955-6864",
            "fax_number": "215-955-2878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3737 Market St",
            "address_2": "Fl 4",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191045545",
            "country_code": "US",
            "telephone_number": "215-662-7320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOVIDES",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "PA",
            "license": "MD471142",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD471142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.