NPIMap

Individual provider Active NPI

Andrenita Antoinette Haddad, CRNP

  • Family Nurse Practitioner
  • Yardley, PA
National Provider Identifier
1417650201
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP027101 Issued in PA
Practice address
128 Knights Bridge Dr
Yardley, PA 19067-6007
Phone
(215) 813-8315
NPI assigned
Mar 22, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP027101 PA
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X SP027101 PA Primary

Addresses

Primary practice location

128 Knights Bridge Dr
Yardley, PA 19067-6007

Mailing address

128 Knights Bridge Dr
Yardley, PA 19067-6007
Phone (215) 813-8315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY, WI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230626001739 PA Practitioner - Nurse Practitioner 3476911371 Reassigns benefits to 1 organization
I20241210001620 NY Practitioner - Nurse Practitioner 3476911371
I20251121001409 WI Practitioner - Nurse Practitioner 3476911371 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Medford Hospital and Clinics IncGroup PAC ID 5799688602, shared by 9 NPIs, 126 clinicians
Divine Savior Healthcare IncGroup PAC ID 5799684007, 135 clinicians

Practice addresses (Care Compare)

135 S Gibson St
Medford, WI 54451-1622
Phone (715) 748-8100

2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 742-4131

Hospital & facility affiliations

  • Aspirus Divine Savior Hospital Hospital, Portage, WI, CCN 520041
  • Aspirus Medford Hospital & Clinics, Inc Hospital, Medford, WI, CCN 521324

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP027101PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Acute Care Physicians, PC CurrentSince Jun 19, 2023 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Nov 12, 2025 Accepting new patients
Jefferson Acute Care Physicians, PC Single Specialty CurrentSince Jun 19, 2023 Accepting new patients
Divine Savior Healthcare, Inc. Single Specialty CurrentSince Nov 12, 2025 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

700 Walnut St
Philadelphia, PA 19106
Phone (215) 503-7300

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

Interoperability endpoints

  • Direct secure messaging: ahaddad556240@bassett.direct-ci.net

Organizations & group practices 6

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 9

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": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1417650201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 KNIGHTS BRIDGE DR",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190676007",
            "telephone_number": "215-813-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 KNIGHTS BRIDGE DR",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190676007",
            "telephone_number": "215-813-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "ANDRENITA",
        "middle_name": "ANTOINETTE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP027101",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP027101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yardley, PA

Sources for this page

Verify at the official NPI Registry.