Jacquelyne Wilson, CRNP in Philadelphia, PA - Medicare Nurse Practitioner

Jacquelyne Wilson, CRNP is a medicare enrolled "Nurse Practitioner" in Philadelphia, Pennsylvania. Her current practice location is 160 E Erie Ave, Philadelphia, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (215) 427-5348.

Jacquelyne Wilson is licensed to practice in Pennsylvania (license number SP026860) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1447962220.

Contact Information

	Jacquelyne Wilson, CRNP
	160 E Erie Ave, Philadelphia, PA 19134-1011
	(215) 427-5348
	Not Available

Map and Direction

Provider's Profile

Full Name	Jacquelyne Wilson
Gender	Female
Speciality	Nurse Practitioner
Location	160 E Erie Ave, Philadelphia, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1447962220
Provider Enumeration Date: 12/23/2022
Last Update Date: 03/21/2023

Medicare PECOS Information:

PECOS PAC ID: 9830569722
Enrollment ID: I20230111000691

Medical Identifiers

Medical identifiers for Jacquelyne Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1447962220	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	SP026860 (Pennsylvania)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jacquelyne Wilson allows following entities to bill medicare on her behalf.

Entity Name	Stc Pediatrics Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144864547 PECOS PAC ID: 7315372323 Enrollment ID: O20200122001254

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacquelyne Wilson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jacquelyne Wilson, CRNP Po Box 13579, Reading, PA 19612-3579 Ph: (484) 628-1324	Jacquelyne Wilson, CRNP 160 E Erie Ave, Philadelphia, PA 19134-1011 Ph: (215) 427-5348

Reviews and Comments

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Jacquelyne Wilson, CRNP - Medicare Nurse Practitioner in Philadelphia, PA