Individual provider Active NPI

Elizabeth King Tacey, CRNP

  • Gerontology Nurse Practitioner
  • Exton, PA
National Provider Identifier
1215309992
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP015469 Issued in PA
Practice address
111 Arrandale Blvd
Exton, PA 19341-2503
Phone
(610) 363-2532
NPI assigned
Oct 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 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 SP015469 PA Primary

Addresses

Primary practice location

111 Arrandale Blvd
Exton, PA 19341-2503

Mailing address

111 Arrandale Blvd
Exton, PA 19341-2503
Phone (610) 363-2532

Other practice location 1

200 Willowbrook Ln Ste 240
West Chester, PA 19382-5697
Phone (610) 363-2532

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
I20151119001237 PA Practitioner - Nurse Practitioner 6608176805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Associates of Chester CountyGroup PAC ID 9234113572, 16 clinicians

Practice addresses (Care Compare)

111 Arrandale Blvd
Exton, PA 19341-2503
Phone (610) 363-2532

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.35

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ear, Nose and Throat Associates of Chester County CurrentSince Feb 1, 2024 Accepting new patients

Locations

111 Arrandale Blvd
Exton, PA 19341
Phone (610) 280-3279

200 Willowbrook Ln
Ste 240
West Chester, PA 19382
Phone (610) 363-2532

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 1

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": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1215309992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ARRANDALE BLVD",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412503",
            "telephone_number": "610-363-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ARRANDALE BLVD",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412503",
            "telephone_number": "610-363-2532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Willowbrook Ln Ste 240",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "PA",
            "postal_code": "193825697",
            "country_code": "US",
            "telephone_number": "610-363-2532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TACEY",
        "first_name": "ELIZABETH",
        "middle_name": "KING",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-21",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP015469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Exton, PA

Sources for this page

Verify at the official NPI Registry.