Individual provider Active NPI

Jennifer A Bernhardt, CRNP

  • Gerontology Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1538537675
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP014495 Issued in PA
Practice address
1 Convention Avenue
Philadelphia, PA 19104
Phone
(267) 862-3999
NPI assigned
Sep 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 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 SP014495 PA Primary

Addresses

Primary practice location

1 Convention Avenue
Philadelphia, PA 19104

Mailing address

1 Convention Avenue
2ND Floor Cardiac Surgery Office
Philadelphia, PA 19104
Phone (267) 862-3999

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
I20151112002069 NJ Practitioner - Nurse Practitioner 6709196264 Reassigns benefits to 1 organization
I20170127002006 PA Practitioner - Nurse Practitioner 6709196264 Reassigns benefits to 2 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
University of Penn-Medical GroupGroup PAC ID 6204730955, shared by 15 NPIs, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Jan 16, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 16, 2017 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Atlanticare Physician Group, PA CurrentSince Oct 1, 2019 Accepting new patients
University of Penn - Medical Group CurrentSince Jan 16, 2017 Accepting new patients
Atlanticare Physician Group PA CurrentSince Oct 1, 2019 Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

2500 English Creek Ave
Ste 800
Egg Hbr Twp, NJ 08234
Phone (609) 407-2277

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

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

3400 Spruce St
Fl 10
Philadelphia, PA 19104

3400 Spruce St
#10
Philadelphia, PA 19104
Phone (215) 662-2096

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.

Hospital & facility affiliations 2

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": "1441584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1538537675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CONVENTION AVENUE",
            "address_2": "2ND FLOOR CARDIAC SURGERY OFFICE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "267-862-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CONVENTION AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "267-862-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNHARDT",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-07",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP014495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.