David Agosto, N.P.
Individual provider Active NPI Registered Nurse · Philadelphia, PA
NPI 1598093031 · NPPES record last updated Jun 9, 2011
Key facts
- NPI
- 1598093031
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- SP010122 (PA)
- Practice address
- 401-55 W. Allegheny Ave.
Philadelphia, PA 19133-3644 - Phone
- (215) 291-2500
- NPI assigned
- Nov 20, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240104001931 | PA | Order and Referring Only - Nurse Practitioner | 9133512080 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP010122 | PA | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | SP010122 | PA | Yes |
Addresses
Primary practice location
401-55 W. Allegheny Ave.
Philadelphia, PA 19133-3644
Mailing address
1412 Fairmount Ave
Philadelphia, PA 19130-2908
Phone (215) 599-4851
Other providers in Philadelphia, PA
- Yasmeen Mele Agosti
- Colby C Agostinelli
- Lindsay Agostinelli
- Andrew Martin Agostini
- Michelle Agostini
- Omar Agosto
- Natalie Agramonte
- Anita Agrawal
- Durgesh Kumar Agrawal
- Kalika Agrawal
All providers in Philadelphia, PA · Registered Nurse in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.