NPIMap

Individual provider Active NPI

Jennifer Marie Millado, PA-C

  • Medical Physician Assistant
  • Phila, PA
National Provider Identifier
1558649137
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
TMA052478 Issued in PA
Practice address
100 E Lehigh Ave
CHC-1
Phila, PA 19125-1012
Phone
(215) 707-1866
Fax
(215) 707-1876
NPI assigned
Jul 29, 2011
Last updated
Oct 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X TMA052478 PA Primary

Addresses

Primary practice location

100 E Lehigh Ave
CHC-1
Phila, PA 19125-1012

Mailing address

PO Box 820933
Phila, PA 19182-0933
Phone (215) 707-1866

Other identifiers 2

IdentifierTypeStateIssuer
597586OtherPAMEDICARE GROUP
CD4829OtherPARAILROAD MEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110927000455 PA Practitioner - Physician Assistant 0941471775 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fair Hill Community PhysiciansGroup PAC ID 1850746215, 11 clinicians

Practice addresses (Care Compare)

100 E Lehigh Ave
Philadelphia, PA 19125-1012
Phone (215) 707-0070

1300 W Lehigh Ave
Philadelphia, PA 19132-2760
Phone (215) 226-8800

133 W Hunting Park Ave
Philadelphia, PA 19140-2717
Phone (215) 324-0600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
TMA052478PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physician Inc. CurrentSince Aug 17, 2011 Accepting new patients
Temple Physicians Inc CurrentSince Aug 17, 2011 Accepting new patients
Temple Physicians Inc Medical Past Accepting new patients
Temple Physicians Inc Past Accepting new patients
Temple Physicians Inc Medical Past Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

100 E Lehigh Ave
#1
Philadelphia, PA 19125
Phone (215) 427-7365

3500 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3656

Organizations & group practices 7

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 8

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": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1558649137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820933",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191820933",
            "telephone_number": "215-707-1866",
            "fax_number": "215-707-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LEHIGH AVE",
            "address_2": "CHC-1",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191251012",
            "telephone_number": "215-707-1866",
            "fax_number": "215-707-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLADO",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "TMA052478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "597586",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CD4829",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

Verify at the official NPI Registry.