Individual provider Active NPI

Jason Azzara, AG-ACNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1992270748
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP019365 Issued in PA
Practice address
10800 Knights Rd
Philadelphia, PA 19114-4200
Phone
(215) 612-4000
NPI assigned
Oct 8, 2018
Last updated
Oct 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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 SP019365 PA Primary

Addresses

Primary practice location

10800 Knights Rd
Philadelphia, PA 19114-4200

Mailing address

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-4609

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190702001361 PA Practitioner - Nurse Practitioner 0547594129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

3998 Red Lion Rd
Philadelphia, PA 19114-1445
Phone (215) 612-5050

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physician Services CurrentSince Apr 29, 2019 Accepting new patients
Aria Health Physician Services Current Accepting new patients
Aria Health Physician Services CurrentSince Apr 29, 2019 Accepting new patients

Locations

380 N Oxford Valley Rd
Langhorne, PA 19047
Phone (215) 949-5000

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

3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060

3998 Red Lion Rd
Ste 214
Philadelphia, PA 19114
Phone (215) 612-5050

5000 Frankford Ave
Ste 1B
Philadelphia, PA 19124
Phone (215) 583-2355

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1992270748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZZARA",
        "first_name": "JASON",
        "credential": "AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP019365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.