Priscilla Korto a Tyler, CRNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP019672 Issued in PA

Practice address

2509 Grove LN
Trevose, PA 19053-6755

Phone

(267) 401-4424

NPI assigned

Feb 1, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• STC Pediatrics LLC

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Philadelphia, PA
  • NPI 1144864547
  Medicare reassignment NPD
• STC Pediatrics LLC

  • Pediatric Pathology Physician
  • Philadelphia, PA
  • NPI 1346884707
  NPD
• STC Pediatrics LLC

  • Ophthalmology Physician
  • Newtown, PA
  • NPI 1548141997
  NPD
• STC Pediatrics LLC

  • Pediatric Allergy/Immunology Physician
  • Philadelphia, PA
  • NPI 1003450420
  NPD (past)

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1033674247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 GROVE LN",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536755",
            "telephone_number": "267-401-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 GROVE LN",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536755",
            "telephone_number": "267-401-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "PRISCILLA",
        "middle_name": "KORTO A",
        "credential": "CRNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP019672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Tainan, MA
• Terrapin West End Pharmacy, LLC
• The Progressions Companies, Inc.
• Transitional Care Solutions
• Trevose Specialty Care Surgical Center, LLC
• V V L S Pharmacy LLC
• Mammen Cherian Vaidian
• Michelle Verona, RD
• Ava Votta
• Ramagopal Vudathu

• Pediatric Nurse Practitioner in Trevose, PA
• Providers in Trevose, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.