Jaclyn Marie Timoney, CRNP
Individual provider Active NPI Family Nurse Practitioner · Feasterville Trevose, PA
NPI 1912372947 · NPPES record last updated Jul 8, 2021
Key facts
- NPI
- 1912372947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- SP015325 (PA)
- Practice address
- 23 Bustleton Pike Ste 200
Feasterville Trevose, PA 19053-6446 - Phone
- (215) 938-3450
- Fax
- (215) 938-3829
- NPI assigned
- Dec 2, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160331000690 | PA | Practitioner - Nurse Practitioner | 1355648601 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP015325 | PA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HR Physician Services | Current |
Accepting new patients | |
| Temple Physicians Inc. | Current |
Accepting new patients | |
| HR Physician Services | Current | Accepting new patients | |
| Temple Physicians Inc | Current | Accepting new patients | |
| HR Physician Services | Current |
Accepting new patients | |
| Temple Physician Inc. | Current |
Accepting new patients | |
| HR Physician Services | Past | Accepting new patients | |
| Temple Physicians Inc | Past | Accepting new patients |
Locations
23 Bustleton Pike
Ste 200
Feasterville Trevose, PA 19053
Phone (215) 464-0770
23 Bustleton Pike
Ste 200A
Feasterville Trevose, PA 19053
Phone (215) 464-0770
515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120
1648 Huntingdon Pike
Ofc 1ST
Meadowbrook, PA 19046
1650 Huntingdon Pike
Ste 357
Meadowbrook, PA 19046
Phone (215) 938-1999
7500 Central Ave
Ste 104
Philadelphia, PA 19111
Phone (215) 742-0712
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP015325 | PA | Yes |
Addresses
Primary practice location
23 Bustleton Pike Ste 200
Feasterville Trevose, PA 19053-6446
Mailing address
1648 Huntingdon Pike
Medical Staff Office 1St FLR
Meadowbrook, PA 19046-8001
Phone (215) 938-3450
Other providers in Feasterville Trevose, PA
- Temple Physician Inc.
- The Big Change Nutrition, LLC
- Alicia Theis
- Josiah Thompson
- Naomi Thompson
- Elizabeth Tirabasso
- Ademola Toriola
- Total Physical Therapy Inc
- Ryan Triglia
- Trinity Health Mid-Atlantic Medical Group
All providers in Feasterville Trevose, PA · Family Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.