Jacqueline Anne Rooney-Udicious, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP009936 Issued in PA

Practice address

729 Grove Ave
Southampton, PA 18966-6008

Phone

(215) 322-0800

Fax

(215) 322-2073

NPI assigned

Jun 18, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: jacqueline.rooney-udicious@direct.einstein.edu

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.

• Einstein Practice Plan Inc

  • Pediatrics Physician
  • Phila, PA
  • NPI 1730132028
  NPD (past)
• Tri-County Pediatrics, Inc

  • Pediatrics Physician
  • Elkins Park, PA
  • NPI 1235176397
  NPD (past)

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1902033772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 GROVE AVE",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189666008",
            "telephone_number": "215-322-0800",
            "fax_number": "215-322-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 GROVE AVE",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189666008",
            "telephone_number": "215-322-0800",
            "fax_number": "215-322-2073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9121 Roosevelt Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191142204",
            "country_code": "US",
            "telephone_number": "215-676-5577",
            "fax_number": "215-676-2485",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 Newtown Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Warminster",
            "state": "PA",
            "postal_code": "189745207",
            "country_code": "US",
            "telephone_number": "215-322-0800",
            "fax_number": "215-672-7042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "821 Huntingdon Pike Ste 207",
            "address_purpose": "LOCATION",
            "city": "Huntingdon Valley",
            "state": "PA",
            "postal_code": "190068372",
            "country_code": "US",
            "telephone_number": "215-322-0800",
            "fax_number": "215-322-2073",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 W Germantown Pike Ste D2",
            "address_purpose": "LOCATION",
            "city": "Norristown",
            "state": "PA",
            "postal_code": "194011386",
            "country_code": "US",
            "telephone_number": "610-277-6400",
            "fax_number": "610-275-8861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1939 W Cheltenham Ave",
            "address_purpose": "LOCATION",
            "city": "Elkins Park",
            "state": "PA",
            "postal_code": "190271046",
            "country_code": "US",
            "telephone_number": "215-884-5715",
            "fax_number": "215-884-1442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROONEY-UDICIOUS",
        "first_name": "JACQUELINE",
        "middle_name": "ANNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP009936",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP009936",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA. RN LICENSE",
            "identifier": "RN565963",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10225936440001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA CERTIFIED NURSE PRACTITIONER LICENSE",
            "identifier": "SP009936",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louise Marie Riendeau, PHARMD, RPH
• Jill Rinius, LCSW
• Earl Barry Rochvarg, DDS
• Kylie Rodenhaber, PSY.D.
• Andrea Paula Roof, PSYD
• Shane Rose
• Matthew Rosenberg, LCSW
• Samantha Rosser
• Jessica Rossi
• Jerry M Roth, MD

• Nurse Practitioner in Southampton, PA
• Providers in Southampton, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.