Individual provider Active NPI

James E Cautillo, CRNP

  • Family Nurse Practitioner
  • Media, PA
National Provider Identifier
1487150959
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP018384 Issued in PA
Practice address
1068 W Baltimore Pike Ste 202
Media, PA 19063
Phone
(484) 337-2580
NPI assigned
Apr 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP018384 PA Primary
Nurse Practitioner 363L00000X SP018384 PA

Addresses

Primary practice location

1068 W Baltimore Pike Ste 202
Media, PA 19063

Mailing address

1068 W Baltimore Pike Ste 202
Media, PA 19063-5104
Phone (484) 337-2580

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
I20180523001230 PA Practitioner - Nurse Practitioner 7315202371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (610) 566-9400

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP018384PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Nurse Practitioner CurrentSince Jun 1, 2018 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400

1068 W Baltimore Pike
Ste 202
Media, PA 19063
Phone (484) 337-2580

240 N Radnor Chester Rd
Ste 100
Wayne, PA 19087
Phone (484) 580-1400

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.

Hospital & facility affiliations 1

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": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1487150959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 W BALTIMORE PIKE STE 202",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635104",
            "telephone_number": "484-337-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 W BALTIMORE PIKE STE 202",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "484-337-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUTILLO",
        "first_name": "JAMES",
        "middle_name": "E",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018384",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP018384",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.