Individual provider Active NPI

Kaitlin Ashley Rancani, MSN, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1083159248
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017013 Issued in PA
Practice address
925 Chestnut St
Philadelphia, PA 19107-4216
Phone
(856) 977-4423
NPI assigned
Dec 27, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP017013 PA Primary

Addresses

Primary practice location

925 Chestnut St
Philadelphia, PA 19107-4216

Mailing address

925 Chestnut St Ste 420a
Philadelphia, PA 19107-4216
Phone (267) 432-4367

Other identifiers 1

IdentifierTypeStateIssuer
103283619MedicaidPA

Other names 1

  • Kaitlin Ashley Mostak Former name

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
I20170530000185 PA Practitioner - Nurse Practitioner 1355618166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Mar 28, 2017 Accepting new patients
Jefferson University Physicians PastSince Apr 5, 2020 Accepting new patients

Locations

925 Chestnut St
Ste 420A
Philadelphia, PA 19107
Phone (215) 955-8516

925 Chestnut St
Fl 3
Philadelphia, PA 19107
Phone (215) 503-6654

925 Chestnut St
Ste 320A
Philadelphia, PA 19107
Phone (215) 955-1175

925 Chestnut St
Philadelphia, PA 19107
Phone (215) 955-5050

1101 Chestnut St
Fl 14
Philadelphia, PA 19107
Phone (215) 955-8084

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

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.

Hospital & facility affiliations 2

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": "1482796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1083159248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST STE 420A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "267-432-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "856-977-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANCANI",
        "first_name": "KAITLIN",
        "middle_name": "ASHLEY",
        "credential": "MSN, CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-27",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103283619",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "MOSTAK",
            "middle_name": "ASHLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.