Individual provider Active NPI

Maduabuchi Prince Gabriel, CRNP FNP-C

  • Family Nurse Practitioner
  • Reading, PA
National Provider Identifier
1215826607
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP033044 Issued in PA
Practice address
1110 Rockland St
Reading, PA 19604-1501
Phone
(071) 743-4060
NPI assigned
Jun 30, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP033044 PA Primary

Addresses

Primary practice location

1110 Rockland St
Reading, PA 19604-1501

Mailing address

3434 Chablis Way
York, PA 17404-8620
Phone (717) 434-0609

Other practice location 1

1 Center Sq Ste 12
Hanover, PA 17331-3012
Phone (717) 434-0609

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
I20251028003418 PA Practitioner - Nurse Practitioner 8628394210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

645 Penn St
Suite 301
Reading, PA 19601-3526

838 Penn St
Reading, PA 19602-1108

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP033044PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reliance Healthcare Inc CurrentSince Feb 10, 2014 Accepting new patients

Locations

1 Center Sq
Ste 12
Hanover, PA 17331
Phone (410) 900-2906

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 6

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": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1215826607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 CHABLIS WAY",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174048620",
            "telephone_number": "717-434-0609",
            "fax_number": "717-434-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 ROCKLAND ST",
            "city": "READING",
            "state": "PA",
            "postal_code": "196041501",
            "telephone_number": "071-743-4060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Center Sq Ste 12",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "PA",
            "postal_code": "173313012",
            "country_code": "US",
            "telephone_number": "717-434-0609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GABRIEL",
        "first_name": "MADUABUCHI",
        "middle_name": "PRINCE",
        "credential": "CRNP FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP033044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

Verify at the official NPI Registry.