Individual provider Active NPI

Katie Michelle Stonelake

  • Cardiovascular Disease Physician
  • Philadelphia, PA
National Provider Identifier
1285141051
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
SP018340 Issued in PA
Practice address
3801 Filbert St
4 HVP
Philadelphia, PA 19104-2640
Phone
(215) 662-9189
Fax
(215) 243-4612
NPI assigned
Jan 3, 2018
Last updated
Jan 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X SP018340 PA Primary

Addresses

Primary practice location

3801 Filbert St
4 HVP
Philadelphia, PA 19104-2640

Mailing address

3801 Filbert St
4 HVP
Philadelphia, PA 19104-2640
Phone (215) 662-9189

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
I20180122000668 PA Practitioner - Nurse Practitioner 6709145717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

51 N 39TH St 4 HVP
Penn Cardiology Penn Presbyterian 4TH Floor
Philadelphia, PA 19104-2640
Phone (215) 662-9189

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Jan 1, 2018 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Current Accepting new patients
Clinical Health Care Associates of New Jersey, PC Cardiovascular Disease CurrentSince Jan 1, 2018 Accepting new patients

Locations

51 N 39th St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-9189

7133 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 333-3311

Organizations & group practices 3

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 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": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1285141051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 FILBERT ST",
            "address_2": "4 HVP",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9189",
            "fax_number": "215-243-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 FILBERT ST",
            "address_2": "4 HVP",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9189",
            "fax_number": "215-243-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONELAKE",
        "first_name": "KATIE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "SP018340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.