NPIMap

Individual provider Active NPI

Jennifer Anne Erickson, N.P.

  • Gerontology Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1992856413
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP007259 Issued in PA
Practice address
7602 Central Ave
Suite 101
Philadelphia, PA 19111-2443
Phone
(215) 969-2900
Fax
(215) 969-1856
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP007259 PA Primary

Addresses

Primary practice location

7602 Central Ave
Suite 101
Philadelphia, PA 19111-2443

Mailing address

2450 W Hunting Park Ave
2ND Floor
Philadelphia, PA 19129-1302
Phone (215) 926-9022

Other identifiers 3

IdentifierTypeStateIssuer
SM1374026OtherPAPENNSYLVANIA BLUESHIELD
500025007OtherPARAILROAD MEDICARE #
07791408OtherPAPROVIDER TYPE 57 ID NUMBE

Other names 1

  • Miss Jennifer Anne Smith Former name

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
I20110706000093 PA Practitioner - Nurse Practitioner 2466630967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Physicians Inc 154 clinicians

Practice addresses (Care Compare)

7602 Central Ave
Suite 101
Philadelphia, PA 19111-2443
Phone (215) 969-2900

Hospital & facility affiliations

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027
  • Philadelphia Protestant Home Nursing home, Philadelphia, PA, CCN 395961

Merit-based Incentive Payment System (MIPS)

Final score
86.51 of 100Reported as group
Quality
65.57
Promoting interoperability
100
Improvement activities
40
Cost
77.55

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physicians Inc. CurrentSince Feb 16, 2017 Accepting new patients
Temple Physician Inc. CurrentSince Feb 16, 2017 Accepting new patients
Temple Physicians Inc Current Accepting new patients
Temple Physicians Inc Past Accepting new patients
Temple Physicians Inc Past Accepting new patients
Temple Physicians Inc. Past Accepting new patients
Temple Physicians Inc Past Accepting new patients

Locations

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

7602 Central Ave
Ste 101
Philadelphia, PA 19111
Phone (215) 342-8330

Organizations & group practices 7

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 9

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1992856413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-926-9022",
            "fax_number": "215-226-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7602 CENTRAL AVE",
            "address_2": "SUITE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112443",
            "telephone_number": "215-969-2900",
            "fax_number": "215-969-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP007259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA BLUESHIELD",
            "identifier": "SM1374026",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE #",
            "identifier": "500025007",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER TYPE 57 ID NUMBE",
            "identifier": "07791408",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SMITH",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.