Individual provider Active NPI

Juliana Omile, MSN, AGNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Paoli, PA
National Provider Identifier
1235589664
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP016177 Issued in PA
Practice address
40 Darby Rd
Paoli, PA 19301-1481
Phone
(610) 999-1908
NPI assigned
Jun 16, 2016
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP016177 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP016177 PA Primary

Addresses

Primary practice location

40 Darby Rd
Paoli, PA 19301-1481

Mailing address

40 Darby Rd
Paoli, PA 19301-1481
Phone (610) 999-1908

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
I20170620000755 PA Practitioner - Nurse Practitioner 8628346483 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3748 W Chester Pike
FL 1
Newtown Square, PA 19073-3252
Phone (267) 796-9187

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP016177PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Row Psychiatric Services, LLC Psychiatric/Mental Health CurrentSince Jan 16, 2021 Accepting new patients
Julie Mental Health Services LLC Psychiatric/Mental Health CurrentSince Mar 14, 2022 Accepting new patients

Locations

40 Lloyd Ave
Ste 206
Malvern, PA 19355
Phone (610) 999-1908

18 Campus Blvd
Ste 100
Newtown Square, PA 19073
Phone (484) 680-7575

40 Darby Rd
Paoli, PA 19301
Phone (610) 999-1908

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1235589664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 DARBY RD",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011481",
            "telephone_number": "610-999-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 DARBY RD",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011481",
            "telephone_number": "610-999-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMILE",
        "first_name": "JULIANA",
        "credential": "MSN, AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP016177",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP016177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.