Individual provider Active NPI

Patricia Kathleen McMenamin

  • Gerontology Nurse Practitioner
  • Plymouth Meeting, PA
National Provider Identifier
1154142818
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP030816 Issued in PA
Practice address
2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone
(610) 272-8221
NPI assigned
Oct 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP030816 PA Primary

Addresses

Primary practice location

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324

Mailing address

220 N Sanatoga Rd
Pottstown, PA 19464-2753
Phone (484) 941-4991

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
I20241120001459 PA Practitioner - Nurse Practitioner 9133654700 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Suburban Geriatric'S, Inc.Group PAC ID 4486551371, 102 clinicians
Suburban Geriatrics II PCGroup PAC ID 9537552419, 107 clinicians
Violet Valley Long Term Care PCGroup PAC ID 9638683915, 55 clinicians

Practice addresses (Care Compare)

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone (610) 272-8221

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Violet Valley Long Term Care PC CurrentSince Aug 18, 2025 Accepting new patients
Suburban Geriatrics, Inc. CurrentSince Oct 11, 2024 Accepting new patients
Suburban Geriatrics II PC CurrentSince Oct 11, 2024 Accepting new patients

Locations

2901 Jolly Rd
Plymouth Mtng, PA 19462
Phone (610) 272-3222

1600 Black Rock Rd
Royersford, PA 19468
Phone (610) 792-2224

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1154142818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N SANATOGA RD",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194642753",
            "telephone_number": "484-941-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 JOLLY RD",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622324",
            "telephone_number": "610-272-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMENAMIN",
        "first_name": "PATRICIA",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP030816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

Verify at the official NPI Registry.