Individual provider Active NPI

Judith Adrianne Neubauer, CRNP

  • Nurse Practitioner
  • Springfield, PA
National Provider Identifier
1366877565
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SPO13020 Issued in PA
Practice address
100 W Sproul Rd Ste 120
Healthplex Pavillion II
Springfield, PA 19064-2033
Phone
(610) 338-1800
Fax
(610) 338-1809
NPI assigned
Sep 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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 SPO13020 PA Primary

Addresses

Primary practice location

100 W Sproul Rd Ste 120
Healthplex Pavillion II
Springfield, PA 19064-2033

Mailing address

100 W Sproul Rd Ste 120
Healthplex Pavillion II
Springfield, PA 19064-2033
Phone (610) 338-1800

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
I20131009001491 PA Practitioner - Nurse Practitioner 4082848833 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SPO13020PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. Current Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2016 Accepting new patients

Locations

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

200 E State St
Ste 106
Media, PA 19063
Phone (610) 480-5176

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

100 W Sproul Rd
Ste 120
Springfield, PA 19064
Phone (610) 338-1800

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, 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": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1366877565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W SPROUL RD STE 120",
            "address_2": "HEALTHPLEX PAVILLION II",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642033",
            "telephone_number": "610-338-1800",
            "fax_number": "610-338-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W SPROUL RD STE 120",
            "address_2": "HEALTHPLEX PAVILLION II",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642033",
            "telephone_number": "610-338-1800",
            "fax_number": "610-338-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUBAUER",
        "first_name": "JUDITH",
        "middle_name": "ADRIANNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SPO13020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, PA

Sources for this page

Verify at the official NPI Registry.