Individual provider Active NPI

Regine Nshimiyimana Maniraho

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1033511191
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP013543 Issued in PA
Practice address
925 Chestnut St Ste 320a
Philadelphia, PA 19107-4216
Phone
(215) 955-8874
NPI assigned
Sep 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00520100 NJ
Family Nurse Practitioner 363LF0000X SP013543 PA Primary

Addresses

Primary practice location

925 Chestnut St Ste 320a
Philadelphia, PA 19107-4216

Mailing address

333 North Ave
Apt 28a
Secane, PA 19018-3534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151118001928 PA Practitioner - Nurse Practitioner 1456651793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00520100NJMDFamily Nurse Practitioner
SP013543PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Jan 16, 2019 Accepting new patients
Alignmed Partners, PC CurrentSince Jan 1, 2018 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

549 Baltimore Pike
Glen Mills, PA 19342
Phone (610) 358-6005

1718 Spring Creek Rd
Macungie, PA 18062
Phone (610) 366-0500

1194 Naamans Creek Rd
Marcus Hook, PA 19060
Phone (610) 358-6005

925 Chestnut St
Fl 3
Philadelphia, PA 19107
Phone (215) 503-6654

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

925 Chestnut St
Ste 320A
Philadelphia, PA 19107
Phone (215) 955-1175

5501 Perkiomen Ave
Reading, PA 19606
Phone (610) 779-0600

800 W Miner St
West Chester, PA 19382
Phone (484) 920-6200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1033511191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 NORTH AVE",
            "address_2": "APT 28A",
            "city": "SECANE",
            "state": "PA",
            "postal_code": "190183534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST STE 320A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "215-955-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NSHIMIYIMANA MANIRAHO",
        "first_name": "REGINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-20",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00520100",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP013543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.