Individual provider Active NPI

Angela Marie Stewart, CRNP, RN FA

  • Adult Health Nurse Practitioner
  • Wilkes Barre, PA
National Provider Identifier
1093029993
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP012771 Issued in PA
Practice address
575 N River St
Wilkes Barre, PA 18764-0999
Phone
(570) 829-8111
Fax
(845) 454-6080
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 547571 NY
Registered Nurse First Assistant 163WR0006X RN528629L PA
Adult Health Nurse Practitioner 363LA2200X 305888 NY
Adult Health Nurse Practitioner 363LA2200X SP012771 PA Primary

Addresses

Primary practice location

575 N River St
Wilkes Barre, PA 18764-0999

Mailing address

575 N River St
Wilkes Barre, PA 18764-0999
Phone (570) 829-8111

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
I20130503000322 PA Practitioner - Nurse Practitioner 8628262730 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Physician Network LLCGroup PAC ID 2668696592, 63 clinicians

Practice addresses (Care Compare)

4 E Main St
Nanticoke, PA 18634-1602
Phone (570) 735-7474

575 N River St
Wilkes Barre, PA 18702-2634
Phone (570) 552-8938

Hospital & facility affiliations

  • Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
547571NYMDRegistered Nurse First Assistant
RN528629LPAMDRegistered Nurse First Assistant
305888NYMDLicensed Practical Nurse
SP012771PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wilkes-Barre Clinic Company LLC CurrentSince Apr 1, 2013 Accepting new patients
Commonwealth Physician Network LLC CurrentSince Jun 1, 2015 Accepting new patients

Locations

4 E Main St
Nanticoke, PA 18634
Phone (570) 258-3939

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

575 N River St
Wilkes Barre Township, PA 18702
Phone (570) 283-3222

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": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1093029993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187640999",
            "telephone_number": "570-829-8111",
            "fax_number": "845-454-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187640999",
            "telephone_number": "570-829-8111",
            "fax_number": "845-454-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CRNP, RN FA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "NY",
            "license": "547571",
            "primary": false
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "PA",
            "license": "RN528629L",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "305888",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP012771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.