Individual provider Active NPI

Tamica Nichole D'Aguiar, CRNP

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1366107393
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP024078 Issued in PA
Practice address
800 Spruce St
Philadelphia, PA 19107-6192
Phone
(215) 829-3000
NPI assigned
Nov 4, 2021
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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 SP024078 PA Primary

Addresses

Primary practice location

800 Spruce St
Philadelphia, PA 19107-6192

Mailing address

501 Silverside Rd Ste 61
Wilmington, DE 19809-1394
Phone (302) 824-1002

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
I20211220000303 PA Practitioner - Nurse Practitioner 6103217518 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Jan 9, 2021 Accepting new patients
TD Advanced Practice Provider Services CurrentSince Jul 13, 2026 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 9, 2021 Accepting new patients

Locations

501 Silverside Rd
Ste 61
Wilmington, DE 19809
Phone (302) 330-8633

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 4

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": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1366107393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SILVERSIDE RD STE 61",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198091394",
            "telephone_number": "302-824-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076192",
            "telephone_number": "215-829-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AGUIAR",
        "first_name": "TAMICA",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP024078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.