Individual provider Active NPI

Krista Kanya, CRNP, RN

  • Pediatric Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1073853198
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
26NJ01060400 Issued in NJ
Practice address
3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Phone
(215) 713-7144
NPI assigned
Feb 26, 2013
Last updated
Sep 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 26NJ01060400 NJ Primary
Pediatric Nurse Practitioner 363LP0200X SP012776 PA
Pediatric Registered Nurse 163WP0200X RN598267 PA

Addresses

Primary practice location

3400 Civic Center Blvd
Philadelphia, PA 19104-5127

Mailing address

4101 Orchard LN
Philadelphia, PA 19154-4417
Phone (215) 713-7144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201020000074 PA Practitioner - Nurse Practitioner 2769802487 Reassigns benefits to 1 organization
I20211004002757 NJ Practitioner - Nurse Practitioner 2769802487 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN598267PAMDPediatric Registered Nurse
26NJ01060400NJMDPediatric Nurse Practitioner
SP012776PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates of New Jersey PC Current Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Jun 29, 2021 Accepting new patients
Children's Healthcare Associates of New Jersey PC CurrentSince Jun 29, 2021 Accepting new patients
Childrens Health Care Associates, Inc Current Accepting new patients
Childen's Health Care Associates Inc. Pediatrics CurrentSince Jul 16, 2020 Accepting new patients
Childrens Health Care Associates, Inc CurrentSince Jul 16, 2020 Accepting new patients

Locations

1 Plainsboro Rd
Plainsboro, NJ 08536
Phone (609) 853-7000

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

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.

NPI Registry JSON

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1073853198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 ORCHARD LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191544417",
            "telephone_number": "215-713-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-713-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANYA",
        "first_name": "KRISTA",
        "credential": "CRNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-26",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ01060400",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP012776",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "PA",
            "license": "RN598267",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.