Individual provider Active NPI

David Agosto, N.P.

  • Registered Nurse
  • Philadelphia, PA
National Provider Identifier
1598093031
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
SP010122 Issued in PA
Practice address
401-55 W. Allegheny Ave.
Philadelphia, PA 19133-3644
Phone
(215) 291-2500
NPI assigned
Nov 20, 2009
Last updated
Jun 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X SP010122 PA Primary

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

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
I20240104001931 PA Order and Referring Only - Nurse Practitioner 9133512080

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1598093031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 FAIRMOUNT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191302908",
            "telephone_number": "215-599-4851",
            "fax_number": "215-232-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401-55 W. ALLEGHENY AVE.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191333644",
            "telephone_number": "215-291-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTO",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-20",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "SP010122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.