Individual provider Active NPI

Maureen Lubas

  • Gerontology Nurse Practitioner
  • Media, PA
National Provider Identifier
1083084040
Registry record updated Oct 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP015383 Issued in PA
Practice address
1098 W Baltimore Pike
Suite 3101
Media, PA 19063-5139
Phone
(610) 891-9277
NPI assigned
Oct 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP015383 PA Primary

Addresses

Primary practice location

1098 W Baltimore Pike
Suite 3101
Media, PA 19063-5139

Mailing address

1098 W Baltimore Pike
Suite 3101
Media, PA 19063-5139

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
I20160114002114 PA Practitioner - Nurse Practitioner 3476856014 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP015383PAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. Current Accepting new patients
David a Thomas, LTD CurrentSince Nov 1, 2020 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Mar 1, 2018 Accepting new patients
David a Thomas, LTD CurrentSince Nov 1, 2020 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Mar 1, 2018 Accepting new patients

Locations

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1098 W Baltimore Pike
Ste 3101
Media, PA 19063
Phone (610) 891-9277

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

Organizations & group practices 5

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": "1443830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443830400000",
    "number": "1083084040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1098 W BALTIMORE PIKE",
            "address_2": "SUITE 3101",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 W BALTIMORE PIKE",
            "address_2": "SUITE 3101",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635139",
            "telephone_number": "610-891-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBAS",
        "first_name": "MAUREEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-03",
        "last_updated": "2015-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP015383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.