Individual provider Active NPI

Jennifer Prophete

  • Medical Physician Assistant
  • New York, NY
National Provider Identifier
1578977708
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
017567 Issued in NY
Practice address
33 W 125TH St
New York, NY 10027-4512
Phone
(212) 289-5795
Fax
(212) 348-5194
NPI assigned
Jun 16, 2014
Last updated
Jun 16, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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 017567 NY Primary

Addresses

Primary practice location

33 W 125TH St
New York, NY 10027-4512

Mailing address

33 W 125TH St
New York, NY 10027-4512
Phone (212) 289-5795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 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
I20171106002884 PA Practitioner - Physician Assistant 9537425657 Reassigns benefits to 2 organizations
I20201008002881 DE Practitioner - Physician Assistant 9537425657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

2010 Levick St
Philadelphia, PA 19149-2928
Phone (215) 537-4755

7000 Holstein Ave
Philadelphia, PA 19153-3292
Phone (215) 365-7510

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017567NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care P.a. CurrentSince Dec 11, 2019 Accepting new patients
American Current Care PA PC CurrentSince Dec 11, 2019 Accepting new patients

Locations

2010 Levick St
Philadelphia, PA 19149
Phone (215) 537-4755

15 Freeport Rd
Ste 100
Pittsburgh, PA 15215
Phone (412) 784-1551

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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, 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": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1578977708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W 125TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274512",
            "telephone_number": "212-289-5795",
            "fax_number": "212-348-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 125TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274512",
            "telephone_number": "212-289-5795",
            "fax_number": "212-348-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROPHETE",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "017567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.