Individual provider Active NPI

Wanda Floros, NP

  • Family Nurse Practitioner
  • Bryn Mawr, PA
National Provider Identifier
1558763433
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP013934 Issued in PA
Practice address
135 S Bryn Mawr Ave Ste 200
Bryn Mawr, PA 19010-3129
Phone
(610) 325-1390
Fax
(610) 325-1373
NPI assigned
Sep 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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 SP013934 PA Primary

Addresses

Primary practice location

135 S Bryn Mawr Ave Ste 200
Bryn Mawr, PA 19010-3129

Mailing address

135 S Bryn Mawr Ave Ste 200
Bryn Mawr, PA 19010-3129
Phone (610) 325-1390

Other practice location 1

1991 Sproul Rd
Suite 300
Broomall, PA 19008-3512
Phone (610) 325-1390

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
I20160114000296 PA Practitioner - Nurse Practitioner 8224106091 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP013934PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Sep 26, 2016 Accepting new patients
Athens Nutrition, LLC Past Accepting new patients

Locations

1991 Sproul Rd
Ste 300
Broomall, PA 19008
Phone (610) 325-1373

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

135 S Bryn Mawr Ave
Ste 200
Bryn Mawr, PA 19010
Phone (610) 325-1390

Interoperability endpoints

  • Direct secure messaging: wanda.floros.1@17257.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1558763433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S BRYN MAWR AVE STE 200",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103129",
            "telephone_number": "610-325-1390",
            "fax_number": "610-325-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S BRYN MAWR AVE STE 200",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103129",
            "telephone_number": "610-325-1390",
            "fax_number": "610-325-1373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1991 Sproul Rd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Broomall",
            "state": "PA",
            "postal_code": "190083512",
            "country_code": "US",
            "telephone_number": "610-325-1390",
            "fax_number": "610-325-1373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLOROS",
        "first_name": "WANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-22",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP013934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.