NPIMap

Individual provider Active NPI

Nicole Leeann Podjed, P.A.-C

  • Medical Physician Assistant
  • Phoenixville, PA
National Provider Identifier
1477862852
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA054511 Issued in PA
Practice address
826 Main St Ste 201
Phoenixville, PA 19460-4459
Phone
(610) 415-1100
Fax
(610) 415-1101
NPI assigned
Oct 1, 2010
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA054511 PA Primary

Addresses

Primary practice location

826 Main St Ste 201
Phoenixville, PA 19460-4459

Mailing address

826 Main St Ste 201
Phoenixville, PA 19460-4459
Phone (610) 415-1100

Other practice location 1

5 S Sunnybrook Rd Ste 300
Pottstown, PA 19464-3285
Phone (610) 415-1100

Other practice location 2

825 Old Lancaster Rd Ste 300
Bryn Mawr, PA 19010-3235
Phone (610) 415-1100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000163 PA Practitioner - Physician Assistant 3577742675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians
Broker,Cramer and Swanson ENT, PCGroup PAC ID 9931001245, 13 clinicians

Practice addresses (Care Compare)

321 N Furnace St
Birdsboro, PA 19508-2057
Phone (610) 582-2250

826 Main St
Suite 201
Phoenixville, PA 19460-4459
Phone (610) 415-1100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA054511PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pottsville ENT, LLC PastSince Feb 1, 2015 Accepting new patients
Broker,Cramer & Swanson ENT, PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBIACA

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1477862852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 MAIN ST STE 201",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194604459",
            "telephone_number": "610-415-1100",
            "fax_number": "610-415-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 MAIN ST STE 201",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194604459",
            "telephone_number": "610-415-1100",
            "fax_number": "610-415-1101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 S Sunnybrook Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Pottstown",
            "state": "PA",
            "postal_code": "194643285",
            "country_code": "US",
            "telephone_number": "610-415-1100",
            "fax_number": "610-415-1101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 Old Lancaster Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Bryn Mawr",
            "state": "PA",
            "postal_code": "190103235",
            "country_code": "US",
            "telephone_number": "610-415-1100",
            "fax_number": "610-415-1101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PODJED",
        "first_name": "NICOLE",
        "middle_name": "LEEANN",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenixville, PA

Sources for this page

Verify at the official NPI Registry.