Individual provider Active NPI

Jennifer Lynn Flannery, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1790040640
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA055543 Issued in PA
Practice address
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone
(215) 456-7890
NPI assigned
Jul 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA055543 PA Primary

Addresses

Primary practice location

5501 Old York Rd
Philadelphia, PA 19141-3018

Mailing address

PO Box 8500-8735
Philadelphia, PA 19178-0001
Phone (215) 456-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20210520000381 NJ Practitioner - Physician Assistant 5991952525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CMC Department of Medicine Group PAGroup PAC ID 2163335878, shared by 5 NPIs, 474 clinicians

Practice addresses (Care Compare)

1 Cooper PLZ
Camden, NJ 08103-1461

1 Plaza Dr
Sewell, NJ 08080-9207
Phone (856) 270-4080

2 Cooper PLZ
Camden, NJ 08103-1461

3 Cooper PLZ
Camden, NJ 08103-1438

501 Fellowship Rd
Suite 101
Mount Laurel, NJ 08054-3419
Phone (856) 642-2133

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.83 of 100Reported as group
Quality
88.78
Promoting interoperability
99
Improvement activities
40
Cost
74.17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Department of Medicine Group PA CurrentSince Mar 25, 2021 Accepting new patients
CMC Department of Medicine Group PA CurrentSince Mar 25, 2021 Accepting new patients
CMC Department of Medicine Group PA CurrentSince Mar 25, 2021 Accepting new patients

Locations

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

3 Cooper Plz
Rm 311
Camden, NJ 08103
Phone (856) 342-2034

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

309 Bridgeboro Rd
Moorestown, NJ 08057
Phone (856) 439-2000

501 Fellowship Rd
Ste 101
Mount Laurel, NJ 08054
Phone (856) 963-3572

Interoperability endpoints

  • Direct secure messaging: jflannery111236@direct.cooperhealth.edu

Organizations & group practices 3

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 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": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1790040640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500-8735",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780001",
            "telephone_number": "215-456-7000",
            "fax_number": "215-254-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANNERY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.