Individual provider Active NPI

Molly Pandola, CRNP

  • Family Nurse Practitioner
  • Glen Mills, PA
National Provider Identifier
1225799406
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP024797 Issued in PA
Practice address
300 Evergreen Dr Ste 200
Glen Mills, PA 19342-1059
Phone
(610) 876-0347
NPI assigned
Jan 10, 2022
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP024797 PA
Family Nurse Practitioner 363LF0000X SP024797 PA Primary

Addresses

Primary practice location

300 Evergreen Dr Ste 200
Glen Mills, PA 19342-1059

Mailing address

300 Evergreen Dr Ste 200
Glen Mills, PA 19342-1059
Phone (610) 876-0347

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220909000068 PA Practitioner - Nurse Practitioner 9638553712 Reassigns benefits to 1 organization
I20240117003687 DE Practitioner - Nurse Practitioner 9638553712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Practice addresses (Care Compare)

200 E State St
Suite 108
Media, PA 19063-3434
Phone (610) 876-0347

2004 Sproul Rd
FL 1
Broomall, PA 19008-3511
Phone (610) 353-0800

201 2ND Ave
Collegeville, PA 19426-3613
Phone (610) 489-7703

300 Evergreen Dr
Glen Mills, PA 19342-1059

701 N Clayton St
Suite 600
Wilmington, DE 19805-3165
Phone (302) 656-2643

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP024797PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedic and Sports Medicine Associates, LTD CurrentSince Aug 16, 2022 Accepting new patients
Premier Orthopaedic and Sports Medicine Associates LTD CurrentSince Aug 16, 2022 Accepting new patients
Orthopedic Sports & Arthritis Surgery Past Accepting new patients

Locations

701 N Clayton St
Ste 600
Wilmington, DE 19805
Phone (302) 656-2643

2004 Sproul Rd
Fl 1
Broomall, PA 19008
Phone (610) 353-0800

300 Evergreen Dr
Ste 200
Glen Mills, PA 19342
Phone (610) 361-4198

200 E State St
Ste 108
Media, PA 19063
Phone (484) 444-0820

5201 Pennell Rd
Ste C
Media, PA 19063
Phone (610) 874-9710

Interoperability endpoints

  • Direct secure messaging: molly.pandola.1@22724.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1225799406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 EVERGREEN DR STE 200",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421059",
            "telephone_number": "610-876-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 EVERGREEN DR STE 200",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421059",
            "telephone_number": "610-876-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDOLA",
        "first_name": "MOLLY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP024797",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP024797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Mills, PA

Sources for this page

Verify at the official NPI Registry.