Individual provider Active NPI

Mrudula Jelish, NP

  • Nurse Practitioner
  • Wilmington, DE
National Provider Identifier
1336584994
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LG-0000672 Issued in DE
Practice address
5651 Limestone Rd
Heartland Care Partners
Wilmington, DE 19808-1217
Phone
(419) 252-6018
Fax
(800) 564-5952
NPI assigned
May 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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 LG-0000672 DE Primary

Addresses

Primary practice location

5651 Limestone Rd
Heartland Care Partners
Wilmington, DE 19808-1217

Mailing address

333 N Summit St FL 7
Heartland Care Partners
Toledo, OH 43604-2615
Phone (419) 252-6018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20130802000148 DE Practitioner - Nurse Practitioner 5991946923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geriatric Medicine Consultants PAGroup PAC ID 0244492072, 27 clinicians

Practice addresses (Care Compare)

1601 Milltown Rd
Suite 2
Wilmington, DE 19808-4047
Phone (302) 543-6165

Hospital & facility affiliations

  • Christianacare Homehealth Home health agency, Wilmington, DE, CCN 087002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LG-0000672DEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Medicine Consultants PA CurrentSince Jan 1, 2023 Accepting new patients
HCR Manorcare Medical Services of Florida LLC Nurse Practitioner CurrentSince May 13, 2013 Accepting new patients

Locations

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

111 Continental Dr
Ste 406
Newark, DE 19713
Phone (302) 368-2630

5651 Limestone Rd
Wilmington, DE 19808
Phone (302) 239-8583

1601 Milltown Rd
Ste 3
Wilmington, DE 19808

1601 Milltown Rd
Ste 2
Wilmington, DE 19808
Phone (302) 463-6542

L2540
Columbus, OH 43260

333 N Summit St
Fl 7
Toledo, OH 43604
Phone (419) 252-5909

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 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": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1336584994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 7",
            "address_2": "HEARTLAND CARE PARTNERS",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-6018",
            "fax_number": "800-564-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 LIMESTONE RD",
            "address_2": "HEARTLAND CARE PARTNERS",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081217",
            "telephone_number": "419-252-6018",
            "fax_number": "800-564-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELISH",
        "first_name": "MRUDULA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-08",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0000672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.