Individual provider Active NPI

Maryellen Theresa O'Hara, CRNP

  • Adult Health Nurse Practitioner
  • Radnor, PA
National Provider Identifier
1366693707
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
VP006835C Issued in PA
Practice address
250 King of Prussia Rd
Radnor, PA 19087-5220
Phone
(610) 902-5625
NPI assigned
Oct 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X VP006835C PA Primary

Addresses

Primary practice location

250 King of Prussia Rd
Radnor, PA 19087-5220

Mailing address

250 King of Prussia Rd
Radnor, PA 19087-5220
Phone (610) 902-5625

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
I20230817004160 PA Practitioner - Nurse Practitioner 4486016763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Orthopaedic and Sports Medicine Associates, LTDGroup PAC ID 5890681092, 218 clinicians

Practice addresses (Care Compare)

2004 Sproul Rd
FL 1
Broomall, PA 19008-3511
Phone (610) 353-0800

4 Industrial Blvd
Paoli, PA 19301-1605

491 John Young Way
Suite 210
Exton, PA 19341-2567
Phone (610) 524-7251

Hospital & facility affiliations

  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
VP006835CPAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedic and Sports Medicine Associates LTD CurrentSince Jul 4, 2023 Accepting new patients
Premier Orthopaedic and Sports Medicine Associates, LTD CurrentSince Jul 4, 2023 Accepting new patients
Orthopedic Sports & Arthritis Surgery Past Accepting new patients

Locations

2004 Sproul Rd
Fl 1
Broomall, PA 19008
Phone (610) 353-0800

300 Springhouse Dr
Ste 200
Collegeville, PA 19426
Phone (610) 409-2754

491 John Young Way
Ste 210
Exton, PA 19341
Phone (610) 524-7251

266 Lancaster Ave
Ste 200
Malvern, PA 19355
Phone (610) 640-4133

4 Industrial Blvd
Ste 165
Paoli, PA 19301
Phone (610) 359-5640

Interoperability endpoints

  • Direct secure messaging: maryellen.o.hara.1@22724.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1222992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222992000000",
    "number": "1366693707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 KING OF PRUSSIA RD",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875220",
            "telephone_number": "610-902-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 KING OF PRUSSIA RD",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875220",
            "telephone_number": "610-902-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HARA",
        "first_name": "MARYELLEN",
        "middle_name": "THERESA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "VP006835C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Radnor, PA

Sources for this page

Verify at the official NPI Registry.