Individual provider Active NPI

Lynda R Formosa, CRNP

  • Family Nurse Practitioner
  • McKeesport, PA
National Provider Identifier
1477665172
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP007728 Issued in PA
Practice address
331 Shaw Ave
McKeesport, PA 15132-2918
Phone
(412) 675-8585
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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 SP007728 PA Primary

Addresses

Primary practice location

331 Shaw Ave
McKeesport, PA 15132-2918

Mailing address

3085 Route 30
Georgetown, PA 15043
Phone (724) 573-4648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP007728PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Familylinks, Inc PastSince Aug 26, 2008 Accepting new patients

Organizations & group practices 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1477665172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 ROUTE 30",
            "city": "GEORGETOWN",
            "state": "PA",
            "postal_code": "15043",
            "telephone_number": "724-573-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 SHAW AVE",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "151322918",
            "telephone_number": "412-675-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMOSA",
        "first_name": "LYNDA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP007728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKeesport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.