Sandra Ellen Pellatt, DNP, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

SP023737 Issued in PA

Practice address

255 W Lancaster Ave Ste 200
Paoli, PA 19301-1763

Phone

(914) 519-8110

NPI assigned

Aug 4, 2021

Last updated

Jul 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment NPD
• Tower Health Medical Group

  dba Hospitalist Services - Tower Health Medical Group

  • Hospitalist Physician
  • West Reading, PA
  • NPI 1245321157
  NPD (past)

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1396419248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 COBBLESTONE DR",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190031241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE STE 200",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "914-519-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLATT",
        "first_name": "SANDRA",
        "middle_name": "ELLEN",
        "credential": "DNP, CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "741763",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "714717",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F431792",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP023737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell H Paulin, MD
• Kimberly Ann Payne, NPC
• Mark William Pearson, DC
• Pediatric Associates of Paoli, PC (Pediatric Associates of Paoli)
• Pediatric Eye Physicians & Surgeons PC
• Ann Marie Pellegrino, CRNP APRNC
• Marissa Pena
• Christina M Penderghest, CRNP
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #00399)
• Pennsylvania Physicians Services, LLC

• Acute Care Nurse Practitioner in Paoli, PA
• Providers in Paoli, PA by specialty
• Acute Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.