Individual provider Active NPI

Susanne Christine Macavoy, CRNP

  • Nurse Practitioner
  • Springfield, PA
National Provider Identifier
1316609134
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP023711 Issued in PA
Practice address
965 Baltimore Pike Ste B2
Springfield, PA 19064-3997
Phone
(484) 573-5116
NPI assigned
Oct 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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 SP023711 PA Primary

Addresses

Primary practice location

965 Baltimore Pike Ste B2
Springfield, PA 19064-3997

Mailing address

184 Windermere Ave
Lansdowne, PA 19050-1540
Phone (484) 716-7843

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
I20220512002602 PA Practitioner - Nurse Practitioner 7315324324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

965 Baltimore Pike
B2
Springfield, PA 19064-3957
Phone (484) 479-2600

Hospital & facility affiliations

  • Main Line Health Home Care & Hospice - Home Health Home health agency, Radnor, PA, CCN 397012
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP023711PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Nurse Practitioner CurrentSince Jan 29, 2022 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

965 Baltimore Pike
Ste B2
Springfield, PA 19064
Phone (484) 479-2600

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1316609134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 WINDERMERE AVE",
            "city": "LANSDOWNE",
            "state": "PA",
            "postal_code": "190501540",
            "telephone_number": "484-716-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 BALTIMORE PIKE STE B2",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643997",
            "telephone_number": "484-573-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACAVOY",
        "first_name": "SUSANNE",
        "middle_name": "CHRISTINE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP023711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, PA

Sources for this page

Verify at the official NPI Registry.