Caitlin Jaeckel, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1237 Spring Garden St
Philadelphia, PA 19123-3469

Phone

(215) 769-3561

NPI assigned

Jan 17, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: bebashitransitiontohope.caitlinjaeckel@150875.advancedmd-direct.com

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.

• Philadelphia Fight

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1760507859
  Medicare reassignment
• Bebashi Transition to Hope

  • Case Management Agency
  • Philadelphia, PA
  • NPI 1487935805
  NPD (past)

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

{
    "created_epoch": "1610841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1912596644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 SPRING GARDEN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191233469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 SPRING GARDEN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191233469",
            "telephone_number": "215-769-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAECKEL",
        "first_name": "CAITLIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-17",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol J Jacques, MSW LCSW
• Guesthia Jacques, LMSW
• Natacha Jacques
• Michael Jacunski, DO
• Jeffery Jadczak, PT
• Emily Jaedicke-Brito
• Ashley Nicole Jaekel
• Bedour Jafar, MD
• Daniel Jafari, MD
• Mohammed Jaffar, RN

• Physician Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.