Active NPI
David Agosto, N.P.
- Registered Nurse
- Philadelphia, PA
National Provider Identifier
1598093031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- SP010122
- Practice address
- 401-55 W. Allegheny Ave.
Philadelphia, PA 19133-3644 - Phone
- (215) 291-2500
- NPI assigned
- Nov 20, 2009
- Last updated
- Jun 9, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.