Individual provider Active NPI

Jessegnia A Velasquez, APRN

  • Women's Health Nurse Practitioner
  • Bryn Mawr, PA
National Provider Identifier
1326581224
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
SP016856 Issued in PA
Practice address
101 S Bryn Mawr Ave Ste 201
Bryn Mawr, PA 19010-3123
Phone
(610) 520-0700
Fax
(610) 520-0744
NPI assigned
Nov 24, 2016
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X APRN11012833 FL
Women's Health Nurse Practitioner 363LW0102X SP016856 PA Primary

Addresses

Primary practice location

101 S Bryn Mawr Ave Ste 201
Bryn Mawr, PA 19010-3123

Mailing address

3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336

Other practice location 1

2700 Healing Way Ste 306
Wesley Chapel, FL 33543-5453
Phone (813) 933-3324

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
I20170118002297 PA Practitioner - Nurse Practitioner 5092097535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1098 W Baltimore Pike
Media, PA 19063-5139
Phone (610) 565-8564

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11012833FLMDWomen's Health Nurse Practitioner
SP016856PAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Jan 15, 2023 Accepting new patients

Locations

101 S Bryn Mawr Ave
Ste 201
Bryn Mawr, PA 19010
Phone (610) 451-4262

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1098 W Baltimore Pike
Ste 3308
Media, PA 19063
Phone (610) 565-8564

1098 W Baltimore Pike
Ste 3402
Media, PA 19063
Phone (610) 565-3250

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

255 W Lancaster Ave
Ste 331
Paoli, PA 19301
Phone (484) 527-2232

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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 4

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": "1479945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1326581224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S BRYN MAWR AVE STE 201",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103123",
            "telephone_number": "610-520-0700",
            "fax_number": "610-520-0744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Healing Way Ste 306",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335435453",
            "country_code": "US",
            "telephone_number": "813-933-3324",
            "fax_number": "813-932-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "JESSEGNIA",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-24",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "APRN11012833",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "PA",
            "license": "SP016856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.