Individual provider Active NPI

Nicole Lynn Jakobowski, AGNP-C

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1487478087
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP030978 Issued in PA
Practice address
1101 Chestnut St FL 16
Philadelphia, PA 19107-3612
Phone
(215) 955-6760
NPI assigned
Nov 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP030978 PA Primary

Addresses

Primary practice location

1101 Chestnut St FL 16
Philadelphia, PA 19107-3612

Mailing address

2406 Coral St
Philadelphia, PA 19125-1609
Phone (202) 285-3250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250502000605 NJ Practitioner - Nurse Practitioner 0446776488 Reassigns benefits to 1 organization
I20250603001843 PA Practitioner - Nurse Practitioner 0446776488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP030978PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Mar 29, 2025 Accepting new patients
Jefferson University Physicians of New Jersey, P.C. Nurse Practitioner CurrentSince Feb 21, 2025 Accepting new patients
Jefferson University Physicians PastSince Nov 17, 2024 Accepting new patients

Locations

2211 Chapel Ave W
Ste 403
Cherry Hill, NJ 08002
Phone (856) 922-5030

443 Laurel Oak Rd
Ste 130
Voorhees, NJ 08043
Phone (856) 741-0122

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

925 Chestnut St
Fl 3
Philadelphia, PA 19107
Phone (215) 503-6654

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

1101 Chestnut St
Fl 16
Philadelphia, PA 19107
Phone (215) 955-6760

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 1

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": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1487478087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 CORAL ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191251609",
            "telephone_number": "202-285-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 CHESTNUT ST FL 16",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073612",
            "telephone_number": "215-955-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKOBOWSKI",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP030978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.