Individual provider Active NPI

Brianna Spatz, CRNP

  • Pediatric Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1417636465
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP026998 Issued in PA
Practice address
3500 Civic Center Blvd
Philadelphia, PA 19104-4395
Phone
(215) 590-1000
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X SP026998 PA Primary

Addresses

Primary practice location

3500 Civic Center Blvd
Philadelphia, PA 19104-4395

Mailing address

1500 Locust St Apt 3416
Philadelphia, PA 19102-4341
Phone (954) 829-4748

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
I20240711004120 PA Practitioner - Nurse Practitioner 4789129982 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP026998PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Childen's Health Care Associates Inc. CurrentSince Apr 29, 2024 Accepting new patients
Childrens Health Care Associates, Inc CurrentSince Apr 29, 2024 Accepting new patients
Childrens Health Care Associates, Inc Current Accepting new patients
Childrens Health Care Associates of New Jersey PC Past Accepting new patients
Childrens Health Care Associates, Inc Past Accepting new patients

Locations

550 S Goddard Blvd
King of Prussia, PA 19406
Phone (610) 337-3232

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

2929 Arch St
Fl 12
Philadelphia, PA 19104

3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1417636465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LOCUST ST APT 3416",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024341",
            "telephone_number": "954-829-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044395",
            "telephone_number": "215-590-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPATZ",
        "first_name": "BRIANNA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP026998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.