Active NPI
Ellen K Boyda, CRNP
- Family Medicine Physician
- Ridley Park, PA
National Provider Identifier
1215977459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- TP004637B
- Practice address
- 3 E Ridley Ave
Ridley Park, PA 19078-3024 - Phone
- (610) 532-8777
- Fax
- (610) 532-1129
- NPI assigned
- Jun 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | TP004637B | PA | Primary |
Addresses
Primary practice location
3 E Ridley Ave
Ridley Park, PA 19078-3024
Mailing address
3 E Ridley Ave
Ridley Park, PA 19078-3024
Phone (610) 532-8777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manos Family Practice PC | Family Medicine | Past | Accepting new patients |
| Pma Medical Specialists | Family Medicine | Past | Accepting new patients |
| Pentahealth, LLC | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HFHIBD
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232582400000",
"number": "1215977459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 E RIDLEY AVE",
"city": "RIDLEY PARK",
"state": "PA",
"postal_code": "190783024",
"telephone_number": "610-532-8777",
"fax_number": "610-532-1129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 E RIDLEY AVE",
"city": "RIDLEY PARK",
"state": "PA",
"postal_code": "190783024",
"telephone_number": "610-532-8777",
"fax_number": "610-532-1129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYDA",
"first_name": "ELLEN",
"middle_name": "K",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-07",
"last_updated": "2009-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "TP004637B",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridley Park, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.