Individual provider Active NPI

Susan Ruth Bossler, CRNP

  • Family Medicine Physician
  • Reading, PA
National Provider Identifier
1215745658
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
SP030574 Issued in PA
Practice address
4001 Crestline Dr
Reading, PA 19606-3022
Phone
(610) 763-1774
NPI assigned
Dec 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X SP030574 PA Primary

Addresses

Primary practice location

4001 Crestline Dr
Reading, PA 19606-3022

Mailing address

4001 Crestline Dr
Reading, PA 19606-3022
Phone (610) 763-1774

Other practice location 1

1600 E High St
Pottstown, PA 19464-5008
Phone (610) 327-7000

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
I20250211002049 PA Practitioner - Nurse Practitioner 7719417427 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians
Pottstown Clinic Company LLCGroup PAC ID 6406857184, 112 clinicians

Practice addresses (Care Compare)

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (484) 337-3000

1600 E High St
Pottstown, PA 19464-5093
Phone (610) 327-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP030574PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pottstown Clinic Company LLC Family Medicine CurrentSince Apr 1, 2025 Accepting new patients
Main Line Healthcare Family Medicine CurrentSince Feb 14, 2026 Accepting new patients

Locations

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

730 S Hanover St
Pottstown, PA 19465
Phone (610) 323-6835

1600 E High St
Pottstown, PA 19464
Phone (610) 327-7485

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

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.

Hospital & facility affiliations 2

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": "1734480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1215745658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 CRESTLINE DR",
            "city": "READING",
            "state": "PA",
            "postal_code": "196063022",
            "telephone_number": "610-763-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 CRESTLINE DR",
            "city": "READING",
            "state": "PA",
            "postal_code": "196063022",
            "telephone_number": "610-763-1774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 E High St",
            "address_purpose": "LOCATION",
            "city": "Pottstown",
            "state": "PA",
            "postal_code": "194645008",
            "country_code": "US",
            "telephone_number": "610-327-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSSLER",
        "first_name": "SUSAN",
        "middle_name": "RUTH",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-18",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "SP030574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

Verify at the official NPI Registry.