Individual provider Active NPI

Michelle Mulderig, CRNP

  • Acute Care Nurse Practitioner
  • Langhorne, PA
National Provider Identifier
1104650027
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP030385 Issued in PA
Practice address
1203 Langhorne Newtown Rd Ste 135
Langhorne, PA 19047-1212
Phone
(215) 750-5050
NPI assigned
Sep 2, 2024
Last updated
Sep 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP030385 PA Primary

Addresses

Primary practice location

1203 Langhorne Newtown Rd Ste 135
Langhorne, PA 19047-1212

Mailing address

72 Skyview Way
Newtown, PA 18940-1190
Phone (215) 595-4295

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
I20240919000007 PA Practitioner - Nurse Practitioner 8022559939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Cancer Specialists P.C.Group PAC ID 7214194091, 44 clinicians

Practice addresses (Care Compare)

1203 Langhorne Newtown Rd
Suite 135
Langhorne, PA 19047-1212
Phone (215) 750-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP030385PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Phila Cancer & Hematology Specialists PC Current Accepting new patients
Hematology-Oncology Group, P.C. Current Accepting new patients
Alliance Cancer Specialists P.C. CurrentSince Sep 9, 2024 Accepting new patients
Alliance Cancer Specialists CurrentSince Sep 9, 2024 Accepting new patients

Locations

1203 Langhorne Newtown Rd
Ste 135
Langhorne, PA 19047
Phone (215) 612-5250

915 Lawn Ave
Ste 202
Sellersville, PA 18960
Phone (215) 453-3300

Organizations & group practices 4

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 1

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": "1725235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1104650027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 SKYVIEW WAY",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401190",
            "telephone_number": "215-595-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 LANGHORNE NEWTOWN RD STE 135",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471212",
            "telephone_number": "215-750-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDERIG",
        "first_name": "MICHELLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-02",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP030385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Langhorne, PA

Sources for this page

Verify at the official NPI Registry.