Individual provider Active NPI

Jill A. Clemmer, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1477594562
Registry record updated Nov 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD429027 Issued in PA
Practice address
51 N 39TH
Philadelphia, PA 19104-2640
Phone
(215) 662-9990
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD429027 PA Primary
Hospitalist Physician 208M00000X MD429027 PA

Addresses

Primary practice location

51 N 39TH
Philadelphia, PA 19104-2640

Mailing address

51 N 39TH
Philadelphia, PA 19104-2640
Phone (215) 662-9990

Other identifiers 2

IdentifierTypeStateIssuer
101671871MedicaidPA
232359401OtherPAMAIN LINE HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20161021000891 MA Practitioner - HospitalistPractitioner - Internal Medicine 8921001603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 354-2551

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
268675MAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Center, Inc. Current Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Internal Medicine CurrentSince Aug 18, 2016 Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Interoperability endpoints

  • Direct secure messaging: clemmer.jill.nsmc@direct.partners.masshiway.net

Organizations & group practices 2

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321660800000",
    "number": "1477594562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMER",
        "first_name": "JILL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2011-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD429027",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD429027",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101671871",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIN LINE HEALTHCARE",
            "identifier": "232359401",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.