Individual provider Active NPI

Anna Leigh Anetor-Jamison, D.O.

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1497119853
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS019922 Issued in PA
Practice address
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone
(215) 456-7170
Fax
(215) 456-4923
NPI assigned
Apr 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X OS019922 PA Primary

Addresses

Primary practice location

5501 Old York Rd
Philadelphia, PA 19141-3018

Mailing address

1600 Rockland Rd
Suite 2B80
Wilmington, DE 19803-3607

Other practice location 1

1600 Rockland Rd
Suite 2B80
Wilmington, DE 19803-3607
Phone (302) 651-5874

Other names 1

  • Anna Leigh Anetor-Jamison Other 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191030000072 PA Practitioner - Pediatric Medicine 9032417282 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Sep 2, 2019 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Einstein Practice Plan Inc CurrentSince Sep 2, 2019 Accepting new patients

Locations

5501 York Rd
Ste 1
Philadelphia, PA 19141
Phone (215) 456-6500

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

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

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

Interoperability endpoints

  • Direct secure messaging: anna.anetor-jamison@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.

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1497119853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "address_2": "SUITE 2B80",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-7170",
            "fax_number": "215-456-4923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Rockland Rd",
            "address_2": "Suite 2B80",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198033607",
            "country_code": "US",
            "telephone_number": "302-651-5874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANETOR-JAMISON",
        "first_name": "ANNA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS019922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "ANETOR-JAMISON",
            "middle_name": "LEIGH",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.