Jessica Nicole Shore, PSYD in Philadelphia, PA - Medicare Psychologist Provider

Jessica Nicole Shore, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Philadelphia, Pennsylvania. Her current practice location is 3535 Market St Fl 3, Philadelphia, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (215) 746-6700.

Jessica Nicole Shore is licensed to practice in Pennsylvania (license number PS016961) 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 1225284516.

Contact Information

	Jessica Nicole Shore, PSYD
	3535 Market St Fl 3, Philadelphia, PA 19104-3317
	(215) 746-6700
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jessica Nicole Shore
Gender	Female
Speciality	Psychologist - Clinical
Location	3535 Market St Fl 3, 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: 1225284516
Provider Enumeration Date: 08/18/2008
Last Update Date: 05/12/2022

Medicare PECOS Information:

PECOS PAC ID: 6800035189
Enrollment ID: I20130618000019

Medical Identifiers

Medical identifiers for Jessica Nicole Shore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225284516	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PS016961 (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. Jessica Nicole Shore allows following entities to bill medicare on her behalf.

Entity Name	Joseph J. Peters Institute
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023177144 PECOS PAC ID: 0749263697 Enrollment ID: O20040610001548

Entity Name	University Of Penn-medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235527342 PECOS PAC ID: 6204730955 Enrollment ID: O20141111000091

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. Jessica Nicole Shore 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
Jessica Nicole Shore, PSYD 100 S Broad St, 17th Floor, Philadelphia, PA 19110 Ph: (267) 603-3673	Jessica Nicole Shore, PSYD 3535 Market St Fl 3, Philadelphia, PA 19104-3317 Ph: (215) 746-6700

Reviews and Comments

Psychologist in Philadelphia, PA

Nancy Allanoff Braveman, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 34th Street & Civic Center Blvd, Philadelphia, PA 19104 Phone: 215-590-7555 Fax: 215-590-7387
Thomas A Bartlett, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1735 Lombard St, Philadelphia, PA 19146 Phone: 215-732-3103 Fax: 215-732-8584
Dr. Michael S. Broder, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1420 Locust St, 7g, Philadelphia, PA 19102 Phone: 215-545-7000 Fax: 215-545-7011
Dr. Melisa English Moore, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 34th & Civic Center Blvd, Philadelphia, PA 19104 Phone: 215-590-7555 Fax: 215-590-7387
Dr. Lisa Marie Boschi, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 90 Rochelle Ave, Philadelphia, PA 19128 Phone: 215-508-3300 Fax: 215-508-3210
Jessica Harpel, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3401 Civic Center Blvd, Philadelphia, PA 19104 Phone: 717-332-5114
Dr. Maria Drvoshanov, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1518 Walnut St Ste 607, Philadelphia, PA 19102 Phone: 571-606-9076

Jessica Nicole Shore, PSYD - Medicare Psychologist in Philadelphia, PA