Individual provider Active NPI

Jennifer Jaye Pascual-Bush, NP

  • Acute Care Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1508132465
Registry record updated Feb 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
20590 Issued in CA
Practice address
1001 Potrero Ave
San Francisco, CA 94110-3518
Phone
(415) 206-8111
NPI assigned
Mar 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2016

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 20590 CA Primary

Addresses

Primary practice location

1001 Potrero Ave
San Francisco, CA 94110-3518

Mailing address

1 Farview Rd
Baltimore, MD 21212-1043
Phone (919) 272-1174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20160408000629 MD Practitioner - Nurse Practitioner 1355507112 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Baltimore Medical CenterGroup PAC ID 1759276975, 350 clinicians

Practice addresses (Care Compare)

3701 N Charles St
South Chapman Building Suite 102
Towson, MD 21204-6808

6535 N Charles St
Baltimore, MD 21204-5822

6565 N Charles St
Baltimore, MD 21204-6808

6569 N Charles St
Suite 505
Baltimore, MD 21204-6808
Phone (443) 849-2658

6569 N Charles St PPW Room
307 GYN Specialists
Baltimore, MD 21204-6808
Phone (443) 849-6123

6569 N Charles Street
504 Hoover Low Vision GBMC
Baltimore, MD 21204-6808
Phone (443) 849-2658

6701 N Charles St
Baltamore, MD 21204-6808

6701 N Charles St BLDG
S Chapman BLDG Suite 102
Baltimore, MD 21204-6808

6701 N Charles St Unit
Baltimore, MD 21204-6808
Phone (443) 849-3131

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20590CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. Acute Care CurrentSince Feb 11, 2019 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Jan 25, 2016 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Jan 25, 2016 Accepting new patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Greater Baltimore Medical Center, Inc. CurrentSince Feb 11, 2019 Accepting new patients
Greater Baltimore Medical Center, Inc Current Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

6565 N Charles St
Ste 203
Towson, MD 21204
Phone (410) 828-3760

6535 N Charles St
Ste 125
Towson, MD 21204
Phone (443) 849-3779

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454803200000",
    "number": "1508132465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FARVIEW RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212121043",
            "telephone_number": "919-272-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCUAL-BUSH",
        "first_name": "JENNIFER",
        "middle_name": "JAYE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-26",
        "last_updated": "2016-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "20590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.