Individual provider Active NPI

Jennifer Geller

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1700639218
Registry record updated May 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MT231780 Issued in PA
Practice address
1015 Walnut St Ste 620
Philadelphia, PA 19107-5005
Phone
(215) 955-6864
NPI assigned
Apr 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT231780 PA Primary

Addresses

Primary practice location

1015 Walnut St Ste 620
Philadelphia, PA 19107-5005

Mailing address

1015 Walnut St Ste 620
Philadelphia, PA 19107-5005

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
I20240625003823 PA Order and Referring Only - General SurgeryPractitioner - General Surgery 8224572722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT231780PAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715990400000",
    "number": "1700639218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 WALNUT ST STE 620",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 WALNUT ST STE 620",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075005",
            "telephone_number": "215-955-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELLER",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT231780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.