Individual provider Active NPI

Suzane W. Villarini, CRNP

  • Adult Health Nurse Practitioner
  • West Chester, PA
National Provider Identifier
1174699862
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
TP000791B Issued in PA
Practice address
1240 Wrights Lane
West Chester, PA 19380
Phone
(610) 431-1210
Fax
(610) 594-2625
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN244249L PA
Adult Health Nurse Practitioner 363LA2200X TP000791B PA Primary

Addresses

Primary practice location

1240 Wrights Lane
West Chester, PA 19380

Mailing address

412 Creamery Way
Suite 400
Exton, PA 19341-2500
Phone (610) 594-7590

Other identifiers 1

IdentifierTypeStateIssuer
1031082070001MedicaidPA

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
I20110210000698 PA Practitioner - Nurse Practitioner 5890975643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pentahealth, LLCGroup PAC ID 9537586672, 67 clinicians

Practice addresses (Care Compare)

1240 Wrights LN
Gateway Medical Associate PC
West Chester, PA 19380-4252
Phone (610) 431-1210

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN244249LPAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pentahealth, LLC CurrentSince Oct 1, 2020 Accepting new patients

Locations

412 Creamery Way
Ste 400
Exton, PA 19341
Phone (610) 269-9448

520 Maple Ave
Ste 4
West Chester, PA 19380
Phone (610) 430-8200

1240 Wrights Ln
West Chester, PA 19380
Phone (610) 431-1210

Interoperability endpoints

  • Direct secure messaging: suzanevillarini@gmacc.allscriptsdirect.net

Organizations & group practices 1

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 4

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174699862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 CREAMERY WAY",
            "address_2": "SUITE 400",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412500",
            "telephone_number": "610-594-7590",
            "fax_number": "610-594-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 WRIGHTS LANE",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "19380",
            "telephone_number": "610-431-1210",
            "fax_number": "610-594-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARINI",
        "first_name": "SUZANE",
        "middle_name": "W.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN244249L",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "TP000791B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031082070001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.