Individual provider Active NPI

Deanna Antoinette Cavallaro Fatzinger, CRNP

  • Family Nurse Practitioner
  • Lansdale, PA
National Provider Identifier
1437924867
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP028584 Issued in PA
Practice address
826 N Broad St
Lansdale, PA 19446-2321
Phone
(215) 855-1054
NPI assigned
Nov 15, 2023
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP028584 PA Primary

Addresses

Primary practice location

826 N Broad St
Lansdale, PA 19446-2321

Mailing address

826 N Broad St
Lansdale, PA 19446-2321
Phone (215) 855-1054

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
I20240124002281 PA Practitioner - Nurse Practitioner 2860845096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green and Seidner Family Practice Associates PCGroup PAC ID 8123001872, 11 clinicians

Practice addresses (Care Compare)

826 N Broad St
Lansdale, PA 19446-2321
Phone (215) 855-1054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP028584PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Green and Seidner Family Practice Associates PC CurrentSince Dec 26, 2023 Accepting new patients
Lansdale Hospital Corporation PastSince Nov 19, 2023 Accepting new patients

Locations

826 N Broad St
Lansdale, PA 19446
Phone (215) 855-1054

Organizations & group practices 2

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": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1437924867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 N BROAD ST",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194462321",
            "telephone_number": "215-855-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 N BROAD ST",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194462321",
            "telephone_number": "215-855-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALLARO FATZINGER",
        "first_name": "DEANNA",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-15",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP028584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

Sources for this page

Verify at the official NPI Registry.