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JESSICA KEAKEALANI CARRILLO DPM
NPI 1508684697
Podiatrist - Foot & Ankle Surgery in Philadelphia, PA

Active since September 28, 2024PECOS Enrolled
3401 N BROAD ST, PHILADELPHIA, PA 19140(800) 836-7536 Get Directions Write a Review

NPPES record last updated: June 23, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 23, 2025, Sep 28, 2024 (2 updates tracked since 2024).

About Jessica Keakealani Carrillo Dpm NPPES

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

JESSICA KEAKEALANI CARRILLO DPM (NPI 1508684697) is an individual foot & ankle surgery provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SC007586) and active in the NPI registry since September 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1508684697
Entity TypeIndividualFemale
Primary Taxonomy213ES0103X
Provider Legal NameJESSICA KEAKEALANI CARRILLOCredential: DPM
Location Address3401 N BROAD STPhiladelphia, PA 19140-5189
Mailing Address1532 Rancho LnNorco, CA 92860-2325 · (949) 606-4057
Phone(800) 836-7536
Sole ProprietorNo
Enumeration DateSeptember 28, 2024
Last NPPES UpdateJune 23, 20252 updates tracked since enumeration
NPPES CertifiedJune 23, 2025
✔ NPI 1508684697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in PA · SC007586
Also ListedPodiatrist · Primary Podiatric MedicineTaxonomy 213EP1101X · License SC007586 (PA)
3401 N BROAD ST, Philadelphia, PA 19140
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Keakealani Carrillo Dpm 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.

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.

DR. JAMIE L. GARFIELD MD
Internal Medicine
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-5864
ELIZABETH DIANE DAUER MD
Surgery
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-3133
MARIA ESTHER ESCORCIA DE LEON M.D.
Internal Medicine
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-1622
JEONGAE YOON M.D.
Anesthesiology
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-3326
DR. SUSETE CARNEIRO M.D.
Surgery
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (201) 317-3485
DR. SARAH DENISE FENERTY M.D.
Radiology (Diagnostic Radiology)
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-7237
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Radiology (Radiation Oncology)
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-4233
EDUARDO DOMINGUEZ CASTILLO M.D.
Internal Medicine (Pulmonary Disease)
3401 N BROAD ST, 812 PARKINSON PAVILION
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-5864

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 Jessica Carrillo's NPI number?

The NPI number for Jessica Carrillo is 1508684697. It was assigned to this individual provider in the NPPES registry on September 28, 2024.

Where is Jessica Carrillo located?

Jessica Carrillo practices at 3401 N Broad St, Philadelphia, PA 19140. The listed phone number is (800) 836-7536.

What is Jessica Carrillo's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Jessica Carrillo enrolled in Medicare?

Yes. Jessica Carrillo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jessica Carrillo was last updated on June 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.