Individual provider Active NPI

Jay S Jenoff, MD

  • Surgical Critical Care Physician
  • Philadelphia, PA
National Provider Identifier
1649323882
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
MD417734 Issued in PA
Practice address
1100 Walnut St
Suite 500
Philadelphia, PA 19107-5563
Phone
(215) 955-6750
Fax
(215) 923-8222
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD417734 PA
Surgical Critical Care Physician 2086S0102X MD417734 PA Primary

Addresses

Primary practice location

1100 Walnut St
Suite 500
Philadelphia, PA 19107-5563

Mailing address

1100 Walnut St
Suite 500
Philadelphia, PA 19107-5563

Other identifiers 2

IdentifierTypeStateIssuer
0126624MedicaidNJ
1018350610005MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070208000025 PA Practitioner - General Surgery 2860494697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (610) 642-1908

1100 Walnut St
Mob 5TH Floor
Philadelphia, PA 19107-5563
Phone (215) 955-6750

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion66
Hernia repair - groin (open)1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD417734PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Surgery CurrentSince Jul 1, 2008 Accepting new patients
Main Line Healthcare Surgery CurrentSince Jul 1, 2023 Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients
Jefferson University Physicians Past Accepting new patients
University of Penn-PA Trauma Surgery Past Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

255 W Lancaster Ave
Ste 331
Paoli, PA 19301
Phone (484) 527-2232

1100 Walnut St
Ste 500
Philadelphia, PA 19107
Phone (215) 955-6750

1100 Walnut St
Fl 5
Philadelphia, PA 19107
Phone (215) 955-6750

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

100 E Lancaster Ave
#275
Wynnewood, PA 19096
Phone (215) 622-3743

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 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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1649323882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WALNUT ST",
            "address_2": "SUITE 500",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WALNUT ST",
            "address_2": "SUITE 500",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075563",
            "telephone_number": "215-955-6750",
            "fax_number": "215-923-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENOFF",
        "first_name": "JAY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD417734",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "PA",
            "license": "MD417734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0126624",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018350610005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.