Individual provider Active NPI

Monika Fischer Ertwine, CPNP-PC

  • Pediatric Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1063132520
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP026234 Issued in PA
Practice address
8556 Bustleton Ave
Philadelphia, PA 19152-1218
Phone
(215) 698-9200
Fax
(215) 698-0816
NPI assigned
Sep 2, 2022
Last updated
Oct 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X SP026234 PA Primary

Addresses

Primary practice location

8556 Bustleton Ave
Philadelphia, PA 19152-1218

Mailing address

101 E Olney Ave Ste 400
Philadelphia, PA 19120-2470
Phone (215) 456-1825

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
I20230111002423 PA Practitioner - Nurse Practitioner 0648640458 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP026234PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Community Health Associates, Inc CurrentSince Oct 3, 2022 Accepting new patients
Einstein Community Health Associates, Inc CurrentSince Oct 3, 2022 Accepting new patients

Locations

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

101 E Olney Ave
Ste C5
Philadelphia, PA 19120
Phone (215) 927-1937

8556 Bustleton Ave
Philadelphia, PA 19152
Phone (215) 333-3500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1063132520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE STE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202470",
            "telephone_number": "215-456-1825",
            "fax_number": "215-456-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8556 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191521218",
            "telephone_number": "215-698-9200",
            "fax_number": "215-698-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTWINE",
        "first_name": "MONIKA",
        "middle_name": "FISCHER",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP026234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.