Individual provider Active NPI

Emily Jacobson

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1386148484
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD472755 Issued in PA
Practice address
3550 Market St
Philadelphia, PA 19104-3329
Phone
(215) 590-2178
NPI assigned
Mar 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD472755 PA Primary

Addresses

Primary practice location

3550 Market St
Philadelphia, PA 19104-3329

Mailing address

3550 Market St Apt Suite
Philadelphia, PA 19104-3329
Phone (215) 590-2178

Other practice location 1

3550 Market St
Philadelphia, PA 19104-3329
Phone (215) 590-2178

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250306000207 PA Practitioner - Pediatric Medicine 9436414752 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD472755PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc Pediatrics CurrentSince Dec 30, 2024 Accepting new patients
Childen's Health Care Associates Inc. CurrentSince Dec 30, 2024 Accepting new patients

Locations

3550 Market St
Philadelphia, PA 19104
Phone (215) 590-2178

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

2929 Arch St
Fl 12
Philadelphia, PA 19104

3550 Market St
Fl 4
Philadelphia, PA 19104
Phone (215) 590-2178

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1386148484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 MARKET ST APT SUITE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043329",
            "telephone_number": "215-590-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043329",
            "telephone_number": "215-590-2178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3550 Market St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191043329",
            "country_code": "US",
            "telephone_number": "215-590-2178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD472755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.