JACQUELYNE WILSON CRNP
NPI 1447962220
Nurse Practitioner in Philadelphia, PA

Q: What is Jacquelyne Wilson's NPI number?

The NPI number for Jacquelyne Wilson is 1447962220. It was assigned to this individual provider in the NPPES registry on December 23, 2022.

Q: What is Jacquelyne Wilson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Jacquelyne Wilson was last updated on March 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 23, 2022PECOS Enrolled

160 E ERIE AVE, PHILADELPHIA, PA 19134(215) 427-5348 Get Directions Write a Review

NPPES record last updated: March 21, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 21, 2023, Dec 23, 2022 (2 updates tracked since 2022).

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About Jacquelyne Wilson Crnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELYNE WILSON CRNP (NPI 1447962220) is an individual nurse practitioner in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP026860) and active in the NPI registry since December 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1447962220

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameJACQUELYNE WILSONCredential: CRNP

Location Address160 E ERIE AVEPhiladelphia, PA 19134-1011

Mailing AddressPo Box 13579Reading, PA 19612-3579 · (484) 628-1324

Phone(215) 427-5348

Sole ProprietorNo

Enumeration DateDecember 23, 2022

Last NPPES UpdateMarch 21, 20232 updates tracked since enumeration

NPPES CertifiedMarch 21, 2023

✔ NPI 1447962220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in PA · SP026860

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

160 E ERIE AVE, Philadelphia, PA 19134

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacquelyne Wilson Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jacquelyne Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Stc Pediatrics LLC

0.2 mi

Pediatrics

3645 N FRONT ST
Philadelphia, PA 19134

Reassigned Medicare billing, Pennsylvania enrollment
479 clinicians in this Medicare group

NPI 1346884574 (215) 427-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19134 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GEOFFREY LIBARNES BAJWA MD

Pediatrics (Neonatal-Perinatal Medicine)

160 E ERIE AVE
PHILADELPHIA, PA 19134

Philadelphia County (215) 427-5000

STC PEDIATRICS LLC

Pediatrics (Pediatric Allergy/Immunology)

160 E ERIE AVE
PHILADELPHIA, PA 19134

Philadelphia County (215) 427-5284

JOANNA OVERTON DO

Student in an Organized Health Care Education/Training Program

160 E ERIE AVE
PHILADELPHIA, PA 19134

Philadelphia County (215) 427-5000

MS. NEHA BUTT MBBS

Student in an Organized Health Care Education/Training Program

160 E ERIE AVE, ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
PHILADELPHIA, PA 19134

Philadelphia County (923) 333-1317

CHRISTOPHER HAINES D.O.

Emergency Medicine

160 E ERIE AVE
PHILADELPHIA, PA 19134

Philadelphia County (215) 427-5369

DR. FRASER HUNTINGTON BROWN M.D.

Radiology (Diagnostic Neuroimaging)

160 E ERIE AVE
PHILADELPHIA, PA 19134

Philadelphia County (215) 427-3725

NORRELL KRISTIN ATKINSON MD

Pediatrics (Child Abuse Pediatrics)

160 E ERIE AVE
PHILADELPHIA, PA 19134

Philadelphia County (215) 427-5000

VICTORIA NICOLE HUDSON CRNP-PC

Nurse Practitioner

160 E ERIE AVE
PHILADELPHIA, PA 19134

Philadelphia County (215) 427-5985

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacquelyne Wilson's NPI number?

The NPI number for Jacquelyne Wilson is 1447962220. It was assigned to this individual provider in the NPPES registry on December 23, 2022.

Where is Jacquelyne Wilson located?

Jacquelyne Wilson practices at 160 E Erie Ave, Philadelphia, PA 19134. The listed phone number is (215) 427-5348.

What is Jacquelyne Wilson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Jacquelyne Wilson enrolled in Medicare?

Yes. Jacquelyne Wilson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacquelyne Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacquelyne Wilson reassigns Medicare benefits to Stc Pediatrics LLC (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacquelyne Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacquelyne Wilson was last updated on March 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.