Individual provider Active NPI

Jacquelyn Levin

  • Gerontology Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1356720403
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP014594 Issued in PA
Practice address
800 Spruce St
Pine 1 West
Philadelphia, PA 19107-6130
Phone
(215) 829-7817
NPI assigned
May 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP014594 PA Primary

Addresses

Primary practice location

800 Spruce St
Pine 1 West
Philadelphia, PA 19107-6130

Mailing address

800 Spruce St
Pine 1 West
Philadelphia, PA 19107-6130
Phone (215) 829-7817

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
I20150610001657 PA Practitioner - Nurse Practitioner 5799006144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5401 Old York Rd
Suite 101
Philadelphia, PA 19141-3045
Phone (215) 663-6067

Hospital & facility affiliations

  • Jefferson Einstein Montgomery Hospital Hospital, East Norriton, PA, CCN 390329
  • Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142
  • Jefferson Lansdale Hospital Hospital, Lansdale, PA, CCN 390012

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc Current Accepting new patients
Einstein Practice Plan Inc CurrentSince Oct 1, 2016 Accepting new patients
Einstein Practice Plan Inc CurrentSince Oct 1, 2016 Accepting new patients

Locations

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

5401 Old York Rd
Ste 101
Philadelphia, PA 19141
Phone (215) 456-6178

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

5501 York Rd
Ste 202
Philadelphia, PA 19141
Phone (215) 254-2630

Interoperability endpoints

  • Direct secure messaging: jacquelyn.levin@direct.einstein.edu

Organizations & group practices 3

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 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": "1432252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1356720403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "address_2": "PINE 1 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-7817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "address_2": "PINE 1 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-7817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "JACQUELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP014594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.