Individual provider Active NPI

Nicole Samantha Tourlitis, CRNP

  • Nurse Practitioner
  • East Norriton, PA
National Provider Identifier
1255058012
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP027033 Issued in PA
Practice address
609 W Germantown Pike Ste 210
East Norriton, PA 19403-4251
Phone
(610) 649-1175
Fax
(610) 279-4841
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP027033 PA Primary

Addresses

Primary practice location

609 W Germantown Pike Ste 210
East Norriton, PA 19403-4251

Mailing address

609 W Germantown Pike Ste 210
East Norriton, PA 19403-4251
Phone (610) 649-1175

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
I20230410000032 PA Practitioner - Nurse Practitioner 4486029253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 615-5858

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Phoenixville Hospital Hospital, Phoenixville, PA, CCN 390127

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP027033PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Apr 21, 2025 Accepting new patients
University of Penn-Medical Group CurrentSince Apr 21, 2025 Accepting new patients

Locations

3400 Civic Center Blvd
#2
Philadelphia, PA 19104
Phone (215) 615-0063

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1255058012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 W GERMANTOWN PIKE STE 210",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194034251",
            "telephone_number": "610-649-1175",
            "fax_number": "610-279-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 W GERMANTOWN PIKE STE 210",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194034251",
            "telephone_number": "610-649-1175",
            "fax_number": "610-279-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOURLITIS",
        "first_name": "NICOLE",
        "middle_name": "SAMANTHA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP027033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Norriton, PA

Sources for this page

Verify at the official NPI Registry.