Individual provider Active NPI

Kaitlin C Pattishall, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1245650712
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP013751 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104-4238
Phone
(215) 662-2050
NPI assigned
Apr 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP013751 PA Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4238

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-2050

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
I20140613001766 PA Practitioner - Nurse Practitioner 8527282565 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Physicians IncGroup PAC ID 2062317233, 154 clinicians

Practice addresses (Care Compare)

1722 Bethlehem Pike
Flourtown, PA 19031-1644
Phone (215) 233-9700

Hospital & facility affiliations

  • Temple Health - Chestnut Hill Hospital Hospital, Philadelphia, PA, CCN 390026

Merit-based Incentive Payment System (MIPS)

Final score
86.51 of 100Reported as group
Quality
65.57
Promoting interoperability
100
Improvement activities
40
Cost
77.55

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physicians Inc. CurrentSince May 1, 2016 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Temple Physicians Inc Current Accepting new patients
Temple Physician Inc. CurrentSince May 1, 2016 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients

Locations

1722 Bethlehem Pike
Flourtown, PA 19031
Phone (215) 233-9700

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

261 Old York Rd
Ste 304
Jenkintown, PA 19046
Phone (215) 884-0313

2118 Cottman Ave
Philadelphia, PA 19149
Phone (215) 342-3020

800 Walnut St
Fl 20
William Penn Annex West, PA 19107
Phone (215) 829-2092

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1245650712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTISHALL",
        "first_name": "KAITLIN",
        "middle_name": "C",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP013751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.