Individual provider Active NPI

Chelsea Marie Lattieri, NP-C

  • Gerontology Nurse Practitioner
  • Duncansville, PA
National Provider Identifier
1265906903
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP019910 Issued in PA
Practice address
1894 Plank Rd
Duncansville, PA 16635-8380
Phone
(814) 940-0407
NPI assigned
Jan 16, 2019
Last updated
Jan 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP019910 PA Primary

Addresses

Primary practice location

1894 Plank Rd
Duncansville, PA 16635-8380

Mailing address

PO Box 967
Duncansville, PA 16635-0967
Phone (814) 940-0407

Other names 1

  • Chelsea Marie Laret Former name

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
I20201022002329 PA Practitioner - Nurse Practitioner 9436579943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleanslate Medical Group of Pennsylvania LLCGroup PAC ID 8426334400, 20 clinicians

Practice addresses (Care Compare)

100 N Wilkes Barre Blvd
Suite 103
Wilkes Barre, PA 18702-5240
Phone (413) 584-2173

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cleanslate Medical Group of Pennsylvania LLC CurrentSince Oct 1, 2020 Accepting new patients

Locations

244 Main St
Northampton, MA 01060

501 Howard Ave
Ste B204
Altoona, PA 16601
Phone (814) 201-2835

940 N New St
Ste 140
Bethlehem, PA 18018
Phone (484) 893-1482

3380 Memphis St
Philadelphia, PA 19134
Phone (215) 426-5566

1020 W Lackawanna Ave
Scranton, PA 18504
Phone (570) 348-2280

397 N 9th Ave
Scranton, PA 18504
Phone (570) 344-8619

100 N Wilkes Barre Blvd
Ste 103
Wilkes Barre, PA 18702
Phone (570) 846-2720

Organizations & group practices 1

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": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1265906903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "166350967",
            "telephone_number": "814-940-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1894 PLANK RD",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "166358380",
            "telephone_number": "814-940-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTIERI",
        "first_name": "CHELSEA",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP019910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHELSEA",
            "last_name": "LARET",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duncansville, PA

Sources for this page

Verify at the official NPI Registry.