Individual provider Active NPI

Jacqueline Peters, CRNP

  • Acute Care Nurse Practitioner
  • Plymouth Meeting, PA
National Provider Identifier
1497110183
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP014744 Issued in PA
Practice address
2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone
(610) 272-8221
NPI assigned
Dec 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP014744 PA Primary

Addresses

Primary practice location

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324

Mailing address

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324

Other names 1

  • Jacqueline Oprysko Former name

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
I20220207002631 PA Practitioner - Nurse Practitioner 6002209491 Reassigns benefits to 4 organizations

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
Suburban Geriatric'S, Inc.Group PAC ID 4486551371, 102 clinicians
Suburban Geriatrics II PCGroup PAC ID 9537552419, 107 clinicians

Practice addresses (Care Compare)

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone (610) 272-8221

Hospital & facility affiliations

  • St Mary Medical Center Hospital, Langhorne, PA, CCN 390258

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP014744PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Nov 3, 2021 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Nov 3, 2021 Accepting new patients
Violet Valley Long Term Care PC CurrentSince Aug 18, 2025 Accepting new patients
Suburban Geriatrics, Inc. CurrentSince Nov 16, 2024 Accepting new patients
Suburban Geriatrics II PC CurrentSince Nov 16, 2024 Accepting new patients

Locations

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

7500 Central Ave
Philadelphia, PA 19111
Phone (215) 214-4100

3500 N Broad St
Rm 1A
Philadelphia, PA 19140
Phone (215) 707-2433

2901 Jolly Rd
Plymouth Mtng, PA 19462
Phone (610) 272-3222

Organizations & group practices 6

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": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1497110183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 JOLLY RD",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 JOLLY RD",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622324",
            "telephone_number": "610-272-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-22",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP014744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "OPRYSKO",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plymouth Meeting, PA

Sources for this page

Verify at the official NPI Registry.