NPIMap

Individual provider Active NPI

Stephen Michael Donnelly, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1144773383
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP016592 Issued in PA
Practice address
333 Cottman Ave
Philadelphia, PA 19111-2434
Phone
(215) 214-3943
NPI assigned
Jul 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Registered Nurse 163WX0200X RN602929 PA
Family Nurse Practitioner 363LF0000X SP016592 PA Primary

Addresses

Primary practice location

333 Cottman Ave
Philadelphia, PA 19111-2434

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (814) 934-3750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161208000125 PA Practitioner - Nurse Practitioner 1052691094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

2701 Dekalb Pike
East Norriton, PA 19401-1820
Phone (215) 707-4000

Hospital & facility affiliations

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027
  • Doylestown Hospital Hospital, Doylestown, PA, CCN 390203
  • Hospital of the Fox Chase Cancer Center Hospital, Philadelphia, PA, CCN 390196
  • Holy Redeemer Hospital and Medical Center Hospital, Meadowbrook, PA, CCN 390097
  • St Luke'S Hospital - Grand View Campus Hospital, Sellersville, PA, CCN 390057

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN602929PAMDOncology Registered Nurse
SP016592PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan, Inc CurrentSince Apr 1, 2021 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Apr 1, 2021 Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients

Locations

1648 Huntingdon Pike
Meadowbrook, PA 19046
Phone (215) 938-3413

2701 DeKalb Pike
Norristown, PA 19401
Phone (215) 335-6000

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

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 and National Provider Directory roles.

Hospital & facility affiliations 12

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": "1469318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1144773383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "814-934-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112434",
            "telephone_number": "215-214-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-24",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "PA",
            "license": "RN602929",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP016592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.