Nicole Dematto, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP015744 Issued in PA

Practice address

154 Exton Square Mall Ste 154
Exton, PA 19341-2440

Phone

(484) 565-1293

NPI assigned

May 26, 2016

Last updated

Jan 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2015

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)

Hospital & facility affiliations

• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD
• Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
  • NPI 1568819084
  Medicare reassignment NPD
• Prospect Health Access Network, Inc.

  • Diagnostic Radiology Physician
  • Chester, PA
  • NPI 1154776797
  NPD
• Prospect Health Access Network, Inc.

  • Cardiovascular Disease Physician
  • Ridley Park, PA
  • NPI 1740637255
  NPD
• Radiology Associates of the Main Line P C

  • Diagnostic Radiology Physician
  • Paoli, PA
  • NPI 1750332003
  NPD
• Main Line Healthcare

  dba Main Line Health Urgent Care and Extended Outpatient Care

  • Urgent Care Clinic/Center
  • Wynnewood, PA
  • NPI 1295214492
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Main Line Hospitals, Inc.

  dba Lankenau Hospital

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1497103790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 WALLLINGFORD AVE",
            "city": "WALLINGFORD",
            "state": "PA",
            "postal_code": "190866134",
            "telephone_number": "610-675-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 EXTON SQUARE MALL STE 154",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412440",
            "telephone_number": "484-565-1293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 Chester Pike",
            "address_purpose": "LOCATION",
            "city": "Sharon Hill",
            "state": "PA",
            "postal_code": "190791902",
            "country_code": "US",
            "telephone_number": "610-586-2122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMATTO",
        "first_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Day
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• Brock Degiorgis, PTA
• Kathleen Del Castillo, MS, NCC, LBS
• Dennis John Deloretta, D.C.
• Denise Marino (CDM-PT, Inc)
• John Kenneth Denlinger, MD
• Dermatology and Skin Surgery Center, PC
• Carolina Mesa Derose, PT
• Designed for Health Chiropractic Clinic PC

• Family Nurse Practitioner in Exton, PA
• Providers in Exton, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.