Individual provider Active NPI

Ellen Fallon Malone, CRNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1124126875
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP003192U Issued in PA
Practice address
51 N 39TH St
4 Phi
Philadelphia, PA 19104
Phone
(215) 662-9189
Fax
(215) 243-4612
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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 SP003192U PA Primary

Addresses

Primary practice location

51 N 39TH St
4 Phi
Philadelphia, PA 19104

Mailing address

51 N 39TH St
4 Phi
Philadelphia, PA 19104-2640
Phone (215) 662-9189

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
I20180816003113 PA Practitioner - Nurse Practitioner 0941559496 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Health Care Associates of New Jersey PCGroup PAC ID 0749180198, 793 clinicians

Practice addresses (Care Compare)

51 N 39TH St 4 HVP
Penn Cardiology Penn Presbyterian 4TH Floor
Philadelphia, PA 19104-2640
Phone (215) 662-9189

Hospital & facility affiliations

  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP003192UPAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Feb 5, 2024 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Clinical Health Care Associates of New Jersey, PC Current Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Aug 26, 2018 Accepting new patients
Main Line Healthcare CurrentSince Mar 1, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Feb 5, 2024 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Aug 26, 2018 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1020 Baltimore Pike
Ste 310
Glen Mills, PA 19342
Phone (484) 227-7532

1088 W Baltimore Pike
Ste 2500
Media, PA 19063
Phone (610) 565-2449

7133 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 333-3311

51 N 39th St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-9189

Organizations & group practices 7

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 5

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1124126875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "address_2": "4 PHI",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9189",
            "fax_number": "215-243-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "address_2": "4 PHI",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-9189",
            "fax_number": "215-243-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "ELLEN",
        "middle_name": "FALLON",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP003192U",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.