Jessica Rose Dejneka · Medical Physician Assistant

3744 Manayunk Ave, Philadelphia, PA 19128-3705

Overview

Jessica Rose Dejneka is a Medical Physician Assistant practicing in Glenside, Pennsylvania. The National Provider Identifier (NPI) is #1861294332, which was assigned on March 26, 2025, and the registration record was last updated on July 24, 2025. The practitioner's main practice location is at 450 S Easton Rd, Glenside, PA 19038-3295; the contact telephone number is 6076843030. The primary taxonomy of Jessica Rose Dejneka is Medical Physician Assistant (363AM0700X), with specialization in Medical. Jessica Rose Dejneka is licensed to practice in the state of Pennsylvania (#MA066761).

Provider Information

NPI 1861294332
Entity Type Individual
Provider Name JESSICA ROSE DEJNEKA
Gender Female
Practice Address 450 S Easton Rd
Glenside
PA 19038-3295
Practice Telephone 6076843030
Mailing Address 3744 Manayunk Ave
Philadelphia
PA 19128-3705
Mailing Telephone 6076843030
Certification Date 2025-07-24
Enumeration Date 2025-03-26
Last Update Date 2025-07-24
Is Sole Proprietor N

Doctor and Clinician Information

PAC ID 1355840224
Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID
Full Name JESSICA ROSE DEJNEKA
Primary Specialty PHYSICIAN ASSISTANT
Address 1101 Market St
Philadelphia
PA 19107-2955

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y363AM0700XPhysician AssistantMedicalMA066761PA

Taxonomy Information

Primary Taxonomy

Code 363AM0700X
Taxonomy Medical Physician Assistant
Classification Physician Assistant
Specialization Medical
Grouping Physician Assistants & Advanced Practice Nursing Providers
Definition: Definition to come...

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Location Information

Street Address 3744 MANAYUNK AVE
City PHILADELPHIA
State PA
Zip Code 19128-3705
Country US

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Richard Alan Weiner 3738 Manayunk Ave, Philadelphia, PA 19128-3705Adult Development & Aging Psychologist2006-06-22

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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.