Individual provider Active NPI

Jessica Rosskam, DO

  • Internal Medicine Physician
  • Paoli, PA
National Provider Identifier
1780147736
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS022874 Issued in PA
Practice address
255 W Lancaster Ave
Paoli, PA 19301-1763
Phone
(484) 565-1510
NPI assigned
Apr 8, 2019
Last updated
Dec 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS022874 PA Primary

Addresses

Primary practice location

255 W Lancaster Ave
Paoli, PA 19301-1763

Mailing address

255 W Lancaster Ave
Paoli, PA 19301-1763

Other practice location 1

2701 Dekalb Pike
East Norriton, PA 19401-1820
Phone (610) 278-2832

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
I20230927001888 PA Practitioner - Internal MedicinePractitioner - Hospitalist 3072848027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Philadelphia College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

130 S Bryn Mawr Ave H
321 GVH Hospital Medical Services Bryn
Bryn Mawr, PA 19010-3121
Phone (484) 337-4097

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS022874PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Internal Medicine CurrentSince Sep 1, 2023 Accepting new patients
Main Line Hospitals, Inc. Past Accepting new patients

Locations

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

130 S Bryn Mawr Ave
Ste H
Bryn Mawr, PA 19010
Phone (484) 337-4097

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

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

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.

Hospital & facility affiliations 3

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1780147736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "484-565-1510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 Dekalb Pike",
            "address_purpose": "LOCATION",
            "city": "East Norriton",
            "state": "PA",
            "postal_code": "194011820",
            "country_code": "US",
            "telephone_number": "610-278-2832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSSKAM",
        "first_name": "JESSICA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS022874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.