Individual provider Active NPI

Joanna Sutor, AGACNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1033781463
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP023081 Issued in PA
Practice address
1025 Walnut St
Philadelphia, PA 19107-5001
Phone
(215) 955-6996
NPI assigned
Jul 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN649831 PA
Registered Nurse 163W00000X 26NR20593500 NJ
Acute Care Nurse Practitioner 363LA2100X SP023081 PA Primary

Addresses

Primary practice location

1025 Walnut St
Philadelphia, PA 19107-5001

Mailing address

225 Church St Apt 2D
Philadelphia, PA 19106-4525
Phone (609) 457-9131

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
I20211021001291 PA Practitioner - Nurse Practitioner 9234527409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
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)

1100 Walnut St
Mob 5TH Floor
Philadelphia, PA 19107-5563
Phone (215) 955-6750

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR20593500NJMDRegistered Nurse
RN649831PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Aug 15, 2021 Accepting new patients
Jefferson University Physicians PastSince Jul 25, 2021 Accepting new patients

Locations

1101 Chestnut St
#8
Philadelphia, PA 19107
Phone (215) 955-5869

1100 Walnut St
Fl 5
Philadelphia, PA 19107
Phone (215) 955-6750

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

Organizations & group practices 2

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": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1033781463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CHURCH ST APT 2D",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064525",
            "telephone_number": "609-457-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 WALNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075001",
            "telephone_number": "215-955-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTOR",
        "first_name": "JOANNA",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN649831",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR20593500",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP023081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.