MEDICARE: JESSICA SPINELLI PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0010-01284	NC
2	363A00000X	Physician Assistant	5601012373	MI
3	363A00000X	Physician Assistant	PA00991	RI
4	363A00000X	Physician Assistant	50.005254RX	OH
5	363A00000X	Physician Assistant	MA053788	PA
6	363A00000X	Physician Assistant	PA9393	MA
7	363A00000X	Physician Assistant	021214	NY

General Provider Information

NPI Number	:	1790955086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SPINELLI PA-C

Provider Business Mailing Address
First Line	:	PO BOX 425
Second Line	:
City	:	LEDERACH
State	:	PA
Zip	:	19450-0425
Country	:	US
Telephone Number	:	800-528-0006
Fax Number	:	732-349-6030

Provider Business Practice Location Address
First Line	:	1 MEDICAL CENTER BLVD
Second Line	:
City	:	CHESTER
State	:	PA
Zip	:	19013-3995
Country	:	US
Telephone Number	:	610-447-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2008
Last Update Date	:	11/14/2025

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