Organization Active NPI

Avanta Primary Care, P.C.

  • Family Nurse Practitioner
  • Horsham, PA
National Provider Identifier
1104763861
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
AVANTA PRIMARY CARE, P.C.
Practice address
300 Welsh Rd Ste 100
Horsham, PA 19044-2248
Phone
(267) 703-5900
Fax
(267) 703-2671
NPI assigned
Apr 30, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Authorized official

Name
Alena Blain, NPNPI 1659018125
Title
Owner
Phone
(917) 388-0381

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

300 Welsh Rd Ste 100
Horsham, PA 19044-2248

Mailing address

3956 Amberton CT
Doylestown, PA 18902-1242
Phone (267) 703-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260615002677 PA Part B Supplier - Clinic/Group Practice 7719459395 Receives reassigned benefits from 1 practitioner
Practice locations: Horsham, PA

National Provider Directory

National Provider Directory

Locations

300 Welsh Rd
Ste 100
Horsham, PA 19044
Phone (267) 209-3410

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1777507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777507200000",
    "number": "1104763861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3956 AMBERTON CT",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189021242",
            "telephone_number": "267-703-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WELSH RD STE 100",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442248",
            "telephone_number": "267-703-5900",
            "fax_number": "267-703-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTA PRIMARY CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-30",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A",
        "authorized_official_last_name": "BLAIN",
        "authorized_official_first_name": "ALENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-388-0381",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Horsham, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.