Individual provider Active NPI

Khrystyna Cox, NP

  • Gerontology Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1497224042
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP019516 Issued in PA
Practice address
3400 Civic Center Blvd
2 East
Philadelphia, PA 19104-5127
Phone
(215) 615-4949
NPI assigned
Nov 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP019516 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd
2 East
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
2 East
Philadelphia, PA 19104-5127
Phone (215) 615-4949

Other practice location 1

354 Hurffville Crosskeys Rd
Sewell, NJ 08080-3552
Phone (856) 557-5460

Other names 1

  • Khrystyna Kerkush Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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
I20181205001084 PA Practitioner - Nurse Practitioner 8022352897 Reassigns benefits to 1 organization
I20230725001233 NJ Practitioner - Nurse Practitioner 8022352897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Pennsylvania State University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

354 Hurffville Crosskeys Rd
BLDG 2
Sewell, NJ 08080-3550
Phone (844) 542-2273

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
SP019516PAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice PC CurrentSince Jul 1, 2023 Accepting new patients
University of Penn - Medical Group CurrentSince Oct 14, 2018 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 14, 2018 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Jul 1, 2023 Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients

Locations

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

73 N Maple Ave
Ste B
Marlton, NJ 08053
Phone (856) 596-0558

73 N Maple Ave
Marlton, NJ 08053
Phone (856) 352-6660

354 Hurffville Crosskeys Rd
Bldg 2
Sewell, NJ 08080
Phone (856) 566-3190

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

3400 Civic Center Blvd
Ste 2E
Philadelphia, PA 19104
Phone (215) 615-0820

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

Organizations & group practices 5

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": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1497224042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "2 EAST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-615-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "2 EAST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-615-4949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "354 Hurffville Crosskeys Rd",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080803552",
            "country_code": "US",
            "telephone_number": "856-557-5460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COX",
        "first_name": "KHRYSTYNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP019516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KHRYSTYNA",
            "last_name": "KERKUSH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.