Individual provider Active NPI

Ellen Bridget Linde, CRNP

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1174754774
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP010391 Issued in PA
Practice address
161 Cecil B Moore Ave Apt 204
Philadelphia, PA 19122-3243
Phone
(215) 585-2144
Fax
(267) 780-8032
NPI assigned
Jul 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP010391 PA Primary

Addresses

Primary practice location

161 Cecil B Moore Ave Apt 204
Philadelphia, PA 19122-3243

Mailing address

142 Grand Ave
Forest City, PA 18421-1056
Phone (570) 267-0437

Other practice location 1

1721 N Main Ave
Scranton, PA 18508-1995
Phone (570) 346-8417

Other identifiers 1

IdentifierTypeStateIssuer
103382027-0007MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MT, FL, IA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20090908000209 PA Practitioner - Nurse Practitioner 1658426176 Reassigns benefits to 1 organization
I20220204001119 MT Practitioner - Nurse Practitioner 1658426176 Reassigns benefits to 1 organization
I20220930002855 FL Practitioner - Nurse Practitioner 1658426176 Reassigns benefits to 1 organization
I20230308003119 IA Practitioner - Nurse Practitioner 1658426176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians

Practice addresses (Care Compare)

Helena, MT 59601
Phone (215) 585-2144

161 Cecil B Moore Ave
Apt 204
Philadelphia, PA 19122-3243
Phone (215) 585-2144

2221 Brickyard Rd
Suite E
Adel, IA 50003-8300
Phone (215) 585-2144

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ophelia Medical Group FL, P.a. CurrentSince Jul 1, 2021 Accepting new patients
Ophelia Medical Group Ny, P.C. PastSince Aug 1, 2020 Accepting new patients

Locations

801 West Bay Dr
Ste 408
Largo, FL 33770

2221 Brickyard Rd
Ste E
Adel, IA 50003

750 W Custer Ave
Ste 3
Helena, MT 59602

2 N Last Chance Gulch
Ste B
Helena, MT 59601

228 Park Ave S
New York, NY 10003
Phone (215) 588-2144

Interoperability endpoints

  • Direct secure messaging: ellen.linde.1@3691.direct.athenahealth.com

Organizations & group practices 2

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": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1174754774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 GRAND AVE",
            "city": "FOREST CITY",
            "state": "PA",
            "postal_code": "184211056",
            "telephone_number": "570-267-0437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 CECIL B MOORE AVE APT 204",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191223243",
            "telephone_number": "215-585-2144",
            "fax_number": "267-780-8032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1721 N Main Ave",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185081995",
            "country_code": "US",
            "telephone_number": "570-346-8417",
            "fax_number": "570-344-3778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINDE",
        "first_name": "ELLEN",
        "middle_name": "BRIDGET",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP010391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103382027-0007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.