Individual provider Active NPI

Eileen M Czerwinski, NP

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1386002798
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP015779 Issued in PA
Practice address
3400 Civic Center Blvd
2 West
Philadelphia, PA 19104-5127
Phone
(215) 614-1618
Fax
(215) 615-3380
NPI assigned
Feb 1, 2016
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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 SP015779 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd
2 West
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
2 West
Philadelphia, PA 19104-5127
Phone (215) 614-1618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160223000823 DE Practitioner - Nurse Practitioner 5496050866 Reassigns benefits to 2 organizations
I20220412000877 PA Practitioner - Nurse Practitioner 5496050866 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP015779PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince Mar 21, 2022 Accepting new patients
Christiana Care Health Services Inc CurrentSince Mar 7, 2016 Accepting new patients
Christiana Care Health Services, Inc Nurse Practitioner Current Accepting new patients
University of Penn-Medical Group CurrentSince Mar 21, 2022 Accepting new patients
University of Penn-Medical Group CurrentSince Mar 21, 2022 Accepting new patients
Christiana Care Health Services Inc CurrentSince Mar 7, 2016 Accepting new patients
Christiana Care Health Services, Inc Nurse Practitioner CurrentSince Mar 7, 2016 Accepting new patients

Locations

200 Hygeia Dr
Newark, DE 19713
Phone (302) 273-1701

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

4755 Ogletown Stanton Rd
Ste 6E88
Newark, DE 19718
Phone (302) 733-4250

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

3400 Civic Center Blvd
#2W
Philadelphia, PA 19104
Phone (215) 614-1618

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Organizations & group practices 7

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": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1386002798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "2 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-614-1618",
            "fax_number": "215-615-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "2 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-614-1618",
            "fax_number": "215-615-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZERWINSKI",
        "first_name": "EILEEN",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP015779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.