Individual provider Active NPI

Kathleen Borsa Malone, CRNP

  • Adult Health Nurse Practitioner
  • Media, PA
National Provider Identifier
1215969530
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
VP004008C Issued in PA
Practice address
605 W State Street
Media, PA 19063
Phone
(610) 565-8600
Fax
(610) 891-9238
NPI assigned
Jul 7, 2006
Last updated
Mar 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X VP004008C PA Primary

Addresses

Primary practice location

605 W State Street
Media, PA 19063

Mailing address

605 W State St
Media, PA 19063-2620

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
I20040310000060 PA Practitioner - Nurse Practitioner 8729976832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

605 W State St
Internal Meds Media
Media, PA 19063-2620
Phone (610) 535-8600

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince Mar 17, 2020 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Adult Health CurrentSince Jul 1, 2007 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 1, 2007 Accepting new patients
University of Penn-Medical Group CurrentSince Mar 17, 2020 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Current Accepting new patients

Locations

605 W State St
Media, PA 19063
Phone (610) 565-8600

1800 Lombard St
Ste 206
Philadelphia, PA 19146
Phone (215) 615-2222

3701 Market St
Fl 7
Philadelphia, PA 19104
Phone (215) 349-5200

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1215969530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 W STATE ST",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 W STATE STREET",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "610-565-8600",
            "fax_number": "610-891-9238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "KATHLEEN",
        "middle_name": "BORSA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "VP004008C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.