Individual provider Active NPI

Mahreen R. Qureshi

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1508175969
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP028533 Issued in PA
Practice address
1412 Fairmount Ave
Philadelphia, PA 19130-2908
Phone
(215) 684-5344
NPI assigned
Oct 4, 2010
Reactivated
Mar 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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 SP028533 PA Primary

Addresses

Primary practice location

1412 Fairmount Ave
Philadelphia, PA 19130-2908

Mailing address

1300 Fayette St Apt 102
Conshohocken, PA 19428-1347
Phone (610) 304-2662

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
I20240417000795 PA Practitioner - Nurse Practitioner 4880033380 Reassigns benefits to 4 organizations

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
Delaware Valley Community Health, Inc.Group PAC ID 8426967175, 28 clinicians

Practice addresses (Care Compare)

1412 22 Fairmount Ave
Philadelphia, PA 19130-2908
Phone (215) 235-9600

400 W Allegheny Ave
BLDG 3
Philadelphia, PA 19133-3614

400 W Allegheny Ave BLDG
3 Maria de Los Santos Express Care
Philadelphia, PA 19133-3614
Phone (215) 546-7501

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP028533PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Valley Community Health, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Delaware Valley Community Health, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Delaware Valley Community Health, Inc. Past Accepting new patients
Delaware Valley Community Health, Inc. Past Accepting new patients
Delaware Valley Community Health, Inc. Past Accepting new patients
Delaware Valley Community Health, Inc. Past Accepting new patients
Delaware Valley Community Health, Inc. Past Accepting new patients
Delaware Valley Community Health, Inc. Past Accepting new patients
Delaware Valley Community Health, Inc. Past Accepting new patients
Delaware Valley Community Health, Inc. Past Accepting new patients

Locations

1401 DeKalb St
Norristown, PA 19401
Phone (610) 275-9400

5901 Market St
Philadelphia, PA 19139
Phone (215) 222-2466

1412 Fairmount Ave
Philadelphia, PA 19130
Phone (215) 235-9600

400 W Allegheny Ave
Bldg 3
Philadelphia, PA 19133
Phone (215) 546-7501

1412 Fairmount Ave
#22
Philadelphia, PA 19130

401 W Allegheny Ave
Philadelphia, PA 19133
Phone (215) 291-2500

800 Chester Pike
Sharon Hill, PA 19079
Phone (610) 534-3636

Interoperability endpoints

  • Direct secure messaging: mahreen.qureshi.p1@direct.dvch.nextgenshare.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1508175969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 FAYETTE ST APT 102",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194281347",
            "telephone_number": "610-304-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 FAIRMOUNT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191302908",
            "telephone_number": "215-684-5344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "MAHREEN",
        "middle_name": "R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "deactivation_date": "2023-11-08",
        "reactivation_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP028533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.