JACQUELINE COUNTESS CRNP
NPI 1700336930
Nurse Practitioner - Gerontology in Philadelphia, PA

Active since October 12, 2016PECOS EnrolledAccepts Medicare Assignment
85.48/100
CMS Quality Rating
3400 SPRUCE ST, 4TH FLOOR SILVERSTEIN- SURGERY, PHILADELPHIA, PA 19104(215) 662-7870 Get Directions Write a Review

NPPES record last updated: October 13, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jacqueline Countess Crnp NPPES

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

JACQUELINE COUNTESS CRNP (NPI 1700336930) is an individual gerontology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP016615) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1700336930
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameJACQUELINE COUNTESSCredential: CRNP
Location Address3400 SPRUCE ST, 4TH FLOOR SILVERSTEIN- SURGERYPhiladelphia, PA 19104-4238
Mailing Address3400 Spruce St, 4th Floor Silverstein- SurgeryPhiladelphia, PA 19104-4238 · (215) 662-7870
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateOctober 12, 2016
Last NPPES UpdateOctober 13, 2016
NPI 1700336930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License Licensed in PA · SP016615
3400 SPRUCE ST, Philadelphia, PA 19104

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jacqueline Countess Crnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8426331042
PECOS Enrollment IDI20170206001802
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
22 services20 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hospital Of Univ Of Pennsylvania

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390111
Location34th & Spruce StsPhiladelphia, PA 19104 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

85.48/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.6
Promoting Interoperability100
Improvement Activities40

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.

Pediatrics
3400 SPRUCE ST, 8 RAVDIN
PHILADELPHIA, PA 19104
Radiology (Diagnostic Radiology)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Anesthesiology
3400 SPRUCE ST, 6 DULLES
PHILADELPHIA, PA 19104
Internal Medicine (Pulmonary Disease)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Student in an Organized Health Care Education/Training Program
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Physician Assistant (Medical)
3400 SPRUCE ST, 4 SILVERSTEIN
PHILADELPHIA, PA 19104
Anesthesiology (Critical Care Medicine)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Radiology (Diagnostic Radiology)
3400 SPRUCE ST
PHILADELPHIA, PA 19104

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 Jacqueline Countess's NPI number?

The NPI number for Jacqueline Countess is 1700336930. It was assigned to this individual provider in the NPPES registry on October 12, 2016.

Where is Jacqueline Countess located?

Jacqueline Countess practices at 3400 Spruce St 4th Floor Silverstein- Surgery, Philadelphia, PA 19104. The listed phone number is (215) 662-7870.

What is Jacqueline Countess's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Jacqueline Countess enrolled in Medicare?

Yes. Jacqueline Countess is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Jacqueline Countess affiliated with any hospitals?

According to CMS data, Jacqueline Countess is affiliated with Hospital Of Univ Of Pennsylvania.

When was this NPI record last updated?

The NPPES record for Jacqueline Countess was last updated on October 13, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.