Individual provider Active NPI

Elaine Justine Walsh, CRNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1043429590
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
26NJ00338700 Issued in NJ
Practice address
3400 Spruce St
1 West Gates
Philadelphia, PA 19104-4206
Phone
(215) 662-2730
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X SP007961 PA
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 26NJ00338700 NJ Primary

Addresses

Primary practice location

3400 Spruce St
1 West Gates
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce St
1 West Gates
Philadelphia, PA 19104-4206

Other names 1

  • Elaine Justine Paul Former name

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ewalsh19305@directvirtua.org
Direct Messaging Address ewalsh19305@directvirtua.org
Direct Messaging Address ewalsh19305@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20130604000309 NJ Practitioner - Nurse Practitioner 3870691207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-7260

3242 Route 206
Bordentown, NJ 08505-4517

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Apr 6, 2013 Accepting new patients
Virtua Medical Group, PA CurrentSince Apr 6, 2013 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1561 Route 38
Ste 6
Lumberton, NJ 08048
Phone (609) 267-2100

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

175 Madison Ave
Fl 3
Mount Holly, NJ 08060
Phone (609) 914-6198

7000 Atrium Way
Ste 6
Mount Laurel, NJ 08054
Phone (856) 206-4500

200 Bowman Dr
Ste 340E366
Voorhees, NJ 08043
Phone (856) 247-7600

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

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.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1043429590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "1 WEST GATES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "1 WEST GATES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "ELAINE",
        "middle_name": "JUSTINE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "PA",
            "license": "SP007961",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NJ",
            "license": "26NJ00338700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewalsh19305@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewalsh19305@directvirtua.org",
            "affiliation": "N",
            "address_1": "200 Bowman Dr Ste 340&E366",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewalsh19305@directvirtua.org",
            "affiliation": "N",
            "address_1": "175 Madison Ave Fl 3",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080602099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELAINE",
            "last_name": "PAUL",
            "middle_name": "JUSTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.