Individual provider Active NPI

Nicole Butrica

  • Physician Assistant
  • Doylestown, PA
National Provider Identifier
1205340767
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA059633 Issued in PA
Practice address
595 W State St
Doylestown, PA 18901-2554
Phone
(267) 872-6716
NPI assigned
Nov 20, 2017
Last updated
Oct 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA059633 PA Primary

Addresses

Primary practice location

595 W State St
Doylestown, PA 18901-2554

Mailing address

539 Spencer LN
Warminster, PA 18974-2740
Phone (267) 872-6716

Other practice location 1

190 W Sproul Rd Ste 101
Springfield, PA 19064-2027
Phone (610) 338-2755

Other practice location 2

175 E Chester Pike
Ridley Park, PA 19078-2212
Phone (610) 595-6000

Other practice location 3

300 Evergreen Dr
Glen Mills, PA 19342-1059
Phone (484) 846-5100

Other practice location 4

30 Medical Center Blvd Bldg 1
Chester, PA 19013-3955
Phone (610) 874-6448

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
I20191202001105 PA Order and Referring Only - Physician Assistant 6800229238

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Psychological Services, LLC PastSince Jul 1, 2015 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1205340767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 SPENCER LN",
            "city": "WARMINSTER",
            "state": "PA",
            "postal_code": "189742740",
            "telephone_number": "267-872-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 W STATE ST",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012554",
            "telephone_number": "267-872-6716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "190 W Sproul Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "PA",
            "postal_code": "190642027",
            "country_code": "US",
            "telephone_number": "610-338-2755",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "175 E Chester Pike",
            "address_purpose": "LOCATION",
            "city": "Ridley Park",
            "state": "PA",
            "postal_code": "190782212",
            "country_code": "US",
            "telephone_number": "610-595-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Evergreen Dr",
            "address_purpose": "LOCATION",
            "city": "Glen Mills",
            "state": "PA",
            "postal_code": "193421059",
            "country_code": "US",
            "telephone_number": "484-846-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 Medical Center Blvd Bldg 1",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "PA",
            "postal_code": "190133955",
            "country_code": "US",
            "telephone_number": "610-874-6448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTRICA",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doylestown, PA

Sources for this page

Verify at the official NPI Registry.