NPIMap

Individual provider Active NPI

Dina Vysotsky, CRNP

  • Family Nurse Practitioner
  • Horsham, PA
National Provider Identifier
1356882377
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017031 Issued in PA
Practice address
680 Blair Mill Rd
Horsham, PA 19044-2223
Phone
(215) 902-9014
NPI assigned
Mar 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP017031 PA Primary

Addresses

Primary practice location

680 Blair Mill Rd
Horsham, PA 19044-2223

Mailing address

680 Blair Mill Rd
Horsham, PA 19044-2223
Phone (215) 902-9014

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dina_vysotsky@optum.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170502000549 PA Practitioner - Nurse Practitioner 9739466616 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Telehealth LLCGroup PAC ID 6608156906, 43 clinicians

Practice addresses (Care Compare)

410 N Krocks Rd
Allentown, PA 18106-9283
Phone (888) 982-8594

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Telehealth, LLC CurrentSince May 14, 2023 Accepting new patients
Infinite Medical PC CurrentSince Jun 15, 2022 Accepting new patients

Locations

250 Skillman St
Ste 202
Brooklyn, NY 11205

150 Sunnyside Blvd
Plainview, NY 11803
Phone (516) 280-8811

498 Washington St
Easton, PA 18042
Phone (610) 253-4821

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 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1356882377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 BLAIR MILL RD",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442223",
            "telephone_number": "215-902-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BLAIR MILL RD",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442223",
            "telephone_number": "215-902-9014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYSOTSKY",
        "first_name": "DINA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dina_vysotsky@optum.com",
            "affiliation": "N",
            "address_1": "680 Blair Mill Rd",
            "city": "Horsham",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190442223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Horsham, PA

Sources for this page

Verify at the official NPI Registry.