NPIMap

Individual provider Active NPI

Mikaela Supplee, CRNP

  • Family Nurse Practitioner
  • Center Valley, PA
National Provider Identifier
1578168423
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP022872 Issued in PA
Practice address
5848 Old Bethlehem Pike Ste 101
Center Valley, PA 18034-9341
Phone
(610) 282-2155
NPI assigned
Nov 30, 2020
Last updated
Nov 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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 SP022872 PA Primary

Addresses

Primary practice location

5848 Old Bethlehem Pike Ste 101
Center Valley, PA 18034-9341

Mailing address

5848 Old Bethlehem Pike Ste 101
Center Valley, PA 18034-9341

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
I20210303000419 PA Practitioner - Nurse Practitioner 1850707696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

5848 Old Bethlehem Pike
Suite 101
Center Valley, PA 18034-9341
Phone (610) 282-2155

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. CurrentSince Dec 23, 2020 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Dec 23, 2020 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

5848 Old Bethlehem Pike
Ste 101
Center Valley, PA 18034
Phone (610) 282-2155

21 N Main St
Coopersburg, PA 18036
Phone (610) 282-4487

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 4

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1578168423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5848 OLD BETHLEHEM PIKE STE 101",
            "city": "CENTER VALLEY",
            "state": "PA",
            "postal_code": "180349341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5848 OLD BETHLEHEM PIKE STE 101",
            "city": "CENTER VALLEY",
            "state": "PA",
            "postal_code": "180349341",
            "telephone_number": "610-282-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPPLEE",
        "first_name": "MIKAELA",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Center Valley, PA

Sources for this page

Verify at the official NPI Registry.