Individual provider Active NPI

Jennifer Lynn Mabold, CRNP

  • Family Nurse Practitioner
  • Pittsburgh, PA
National Provider Identifier
1164562492
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TP006405B Issued in PA
Practice address
5115 Centre Ave FL 2
Pittsburgh, PA 15232-1301
Phone
(412) 692-2606
Fax
(412) 692-2610
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X TP006405B PA Primary

Addresses

Primary practice location

5115 Centre Ave FL 2
Pittsburgh, PA 15232-1301

Mailing address

318 Glade Run Rd
Evans City, PA 16033-7720
Phone (724) 586-1192

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
I20040210000512 PA Practitioner - Nurse Practitioner 4385538545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians

Practice addresses (Care Compare)

200 Lothrop St
Pittsburgh, PA 15213-2546
Phone (412) 383-1370

300 Halket St
Pittsburgh, PA 15213-3108

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP006405BPAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Jan 1, 2003 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
University of Pittsburgh Physicians CurrentSince Jan 1, 2003 Accepting new patients
Upmc Emergency Medicine Inc Past Accepting new patients
Oncology Hematology Association Inc Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

5115 Centre Ave
Fl 2
Pittsburgh, PA 15232
Phone (412) 623-3395

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

5115 Centre Ave
Fl 5
Pittsburgh, PA 15232
Phone (412) 692-4724

5150 Centre Ave
Shadyside, PA 15232
Phone (412) 623-4861

Organizations & group practices 6

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164562492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 GLADE RUN RD",
            "city": "EVANS CITY",
            "state": "PA",
            "postal_code": "160337720",
            "telephone_number": "724-586-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 CENTRE AVE FL 2",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152321301",
            "telephone_number": "412-692-2606",
            "fax_number": "412-692-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABOLD",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "TP006405B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.