NPIMap

Individual provider Active NPI

Elizabeth Grugan Tucciarone, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1063791416
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP011215 Issued in PA
Practice address
Broad and Vine Street
Philadelphia, PA 19102
Phone
(215) 762-1020
NPI assigned
Aug 16, 2011
Last updated
Aug 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN588117 PA
Family Nurse Practitioner 363LF0000X SP011215 PA Primary

Addresses

Primary practice location

Broad and Vine Street
Philadelphia, PA 19102

Mailing address

1724 Shelmire Ave
Philadelphia, PA 19111-3427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131009001188 PA Practitioner - Nurse Practitioner 2264666106 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

9910 Frankford Ave
Philadelphia, PA 19114-1900
Phone (215) 632-2636

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN588117PAMDRegistered Nurse
SP011215PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Acute Care Physicians, PC CurrentSince Dec 1, 2022 Accepting new patients
Jefferson University Physicians CurrentSince Dec 1, 2022 Accepting new patients
Aria Health Physician Services CurrentSince Sep 1, 2013 Accepting new patients
Jefferson Acute Care Physicians, PC Current Accepting new patients
Aria Health Physician Services Current Accepting new patients
Aria Health Physician Services Past Accepting new patients

Locations

10101 Academy Rd
Ste 104
Philadelphia, PA 19114
Phone (215) 632-4000

1020 Sansom St
Ste 239
Philadelphia, PA 19107
Phone (215) 955-6844

700 Walnut St
Philadelphia, PA 19106
Phone (215) 503-7300

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

9501 Roosevelt Blvd
Ste 100
Philadelphia, PA 19114
Phone (215) 624-6162

9910 Frankford Ave
Philadelphia, PA 19114
Phone (215) 632-2636

Organizations & group practices 6

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.

Hospital & facility affiliations 9

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": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1063791416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 SHELMIRE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191113427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROAD AND VINE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-762-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCCIARONE",
        "first_name": "ELIZABETH",
        "middle_name": "GRUGAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN588117",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP011215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.