Christina M Defamio, CRNP
Individual provider Active NPI Adult Health Nurse Practitioner · Philadelphia, PA
NPI 1134428527 · NPPES record last updated Mar 28, 2011
Key facts
- NPI
- 1134428527
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- VP001697V (PA)
- Practice address
- 909 Walnut St FL 2
Philadelphia, PA 19107-5211 - Phone
- (215) 955-7000
- Fax
- (215) 503-7007
- NPI assigned
- Mar 24, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Atlanticare Physician Group PA
Practice addresses (Care Compare)
1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone (609) 441-8146
Hospital & facility affiliations
- Atlanticare Regional Medical Center - City Campus
- Shore Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141212001613 | NJ | Practitioner - Nurse Practitioner | 6800118217 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ00159300 | NJ | MD | Adult Health Nurse Practitioner |
| VP001697V | PA | MD | Adult Health Nurse Practitioner |
| VP003665B | PA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlanticare Regional Medical Center | Current |
Accepting new patients | |
| Signify Health Medical Associates of New Jersey, LLC | Current |
Accepting new patients | |
| Atlanticare Regional Medical Center | Current |
Accepting new patients | |
| Atlanticare Physician Group, PA | Current |
Accepting new patients | |
| Atlanticare Physician Group | Current |
Accepting new patients | |
| Atlanticare Physician Group PA | Current | Accepting new patients | |
| Intellihealth, Inc. | Past | Accepting new patients | |
| Atlanticare Regional Medical Center | Adult Health | Past | Accepting new patients |
| Atlanticare Physician Group | Past | Accepting new patients |
Locations
7 S Ohio Ave
Ste 1400
Atlantic City, NJ 08401
Phone (609) 572-8600
1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023
459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815
65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414
116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | VP003665B | PA | |
| Adult Health Nurse Practitioner | 363LA2200X | VP001697V | PA | Yes |
| Adult Health Nurse Practitioner | 363LA2200X | 26NJ00159300 | NJ |
Addresses
Primary practice location
909 Walnut St FL 2
Philadelphia, PA 19107-5211
Mailing address
909 Walnut St FL 2
Philadelphia, PA 19107-5211
Phone (215) 955-7000
Other providers in Philadelphia, PA
- Phillip Deerwester
- Adina Marie Dees
- Anthony Deeugenio III
- Deborah Deeugenio
- Lewis John Deeugenio
- Carly Defaria
- Christina Nicole Defelice
- Jamie-Marie Defelice
- Magee L. Defelice
- Sarah Ruth Defelice
All providers in Philadelphia, PA · Adult Health Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.