Individual provider Active NPI

Jessica Sucharski, CRNP

  • Family Nurse Practitioner
  • Glen Mills, PA
National Provider Identifier
1760208011
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP029066 Issued in PA
Practice address
1788 Wilmington Pike
Glen Mills, PA 19342
Phone
(610) 744-2960
NPI assigned
Dec 2, 2024
Last updated
Dec 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP029066 PA Primary

Addresses

Primary practice location

1788 Wilmington Pike
Glen Mills, PA 19342

Mailing address

1788 Wilmington Pike
Suite 100
Glen Mills, PA 19342
Phone (610) 774-2960

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250617001180 PA Practitioner - Nurse Practitioner 9133630122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 Charles Ellis Dr
Apt 411
Newtown Square, PA 19073-1320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP029066PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Joel S. Goldberg PastSince Apr 3, 2025 Accepting new patients

Organizations & group practices 2

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": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1760208011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1788 WILMINGTON PIKE",
            "address_2": "SUITE 100",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "19342",
            "telephone_number": "610-774-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1788 WILMINGTON PIKE",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "19342",
            "telephone_number": "610-744-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCHARSKI",
        "first_name": "JESSICA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP029066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Mills, PA

Sources for this page

Verify at the official NPI Registry.