NPIMap

Individual provider Active NPI

Jolly S Varghese, CRNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1902390461
Registry record updated Dec 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP018875 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-5864
Fax
(215) 707-6867
NPI assigned
Jun 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP018875 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-2433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190109002476 PA Practitioner - Nurse Practitioner 1456697697 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Critical Care Physicians of Pennsylvania PC 51 clinicians
Temple Physicians Inc 154 clinicians

Practice addresses (Care Compare)

2601 Holme Ave
Philadelphia, PA 19152-2007
Phone (866) 212-7753

7600 Central Ave
Philadelphia, PA 19111-2499
Phone (215) 728-2000

Hospital & facility affiliations

  • Nazareth Hospital Hospital, Philadelphia, PA, CCN 390204
  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP018875PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physicians Inc Current Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jul 21, 2024 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 9, 2019 Accepting new patients
Temple Physicians Inc CurrentSince Sep 6, 2021 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Mar 9, 2019 Accepting new patients
Einstein Practice Plan Inc CurrentSince Oct 1, 2023 Accepting new patients
Einstein Practice Plan Inc CurrentSince Oct 1, 2023 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Critical Care Physicians of Pennsylvania PC CurrentSince Mar 18, 2025 Accepting new patients
Temple Physician Inc. CurrentSince Sep 6, 2021 Accepting new patients

Locations

1500 Lansdowne Ave
Darby, PA 19023
Phone (610) 237-4561

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

600 N 2nd St
Ste 401
Harrisburg, PA 17101
Phone (844) 341-2339

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

8815 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8145

2601 Holme Ave
Philadelphia, PA 19152
Phone (215) 335-6000

5401 Old York Rd
Ste 509
Philadelphia, PA 19141
Phone (215) 456-4985

4900 Frankford Ave
Philadelphia, PA 19124
Phone (215) 612-2610

10800 Knights Rd
Philadelphia, PA 19114
Phone (215) 612-2610

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

2317 E Westmoreland St
Philadelphia, PA 19134
Phone (215) 291-3115

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

559 W Germantown Pike
West Norriton, PA 19403
Phone (484) 622-1000

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: jvarghese3836990@direct.trinity-health.org

Organizations & group practices 12

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 8

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": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638662400000",
    "number": "1902390461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-5864",
            "fax_number": "215-707-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "JOLLY",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2021-12-05",
        "certification_date": "2021-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP018875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.