Individual provider Active NPI

Viyaleta Vaitulevich, CRNP

  • Family Nurse Practitioner
  • Media, PA
National Provider Identifier
1235671892
Registry record updated Jun 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017108 Issued in PA
Practice address
1068 W Baltimore Pike
Media, PA 19063-5104
Phone
(484) 227-3268
NPI assigned
Nov 14, 2016
Last updated
Jun 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP017108 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1068 W Baltimore Pike
Media, PA 19063-5104

Mailing address

1068 W Baltimore Pike
Media, PA 19063-5104

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
I20170725000323 PA Practitioner - Nurse Practitioner 3971873951 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pottstown Clinic Company LLCGroup PAC ID 6406857184, 112 clinicians

Practice addresses (Care Compare)

1600 E High St
Pottstown, PA 19464-5093
Phone (610) 327-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.7 of 100Reported as group
Quality
76.12
Promoting interoperability
99
Improvement activities
40
Cost
73.71

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pottstown Clinic Company LLC CurrentSince Jul 1, 2020 Accepting new patients

Locations

1600 E High St
Pottstown, PA 19464
Phone (610) 327-7485

730 S Hanover St
Pottstown, PA 19465
Phone (610) 323-6835

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.

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": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1235671892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 W BALTIMORE PIKE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 W BALTIMORE PIKE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635104",
            "telephone_number": "484-227-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAITULEVICH",
        "first_name": "VIYALETA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017108",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.