Myrna I Alicea, CRNP

Key facts

NPI

1619099397

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

SP009402 (PA)

Practice address

1203 Langhorne Newtown Rd
Suite 320
Langhorne, PA 19047

Phone

(215) 750-7818

Fax

(215) 752-0436

NPI assigned

Apr 4, 2007

Sex

Female

Sole proprietor

No

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Trinity Health Mid-Atlantic Medical Group Surgery Physician · Langhorne, PA · NPI 1972982361
  Medicare reassignment Care Compare group NPD PA
• Via Affiliates Vascular Surgery Physician · Doylestown, PA · NPI 1003446261
  Medicare reassignment NPD PA
• Trinity Health Mid-Atlantic Medical Group Physical Medicine & Rehabilitation Physician · Philadelphia, PA · NPI 1639039175
  NPD
• Trinity Health Mid-Atlantic Medical Group Family Medicine Physician · Levittown, PA · NPI 1982910931
  NPD
• Via Affiliates Specialist · Doylestown, PA · NPI 1386136364
  NPD
• Via Affiliates Psychologist · Warrington, PA · NPI 1588489272
  NPD
• Trinity Health Mid-Atlantic Medical Group Trauma Surgery Physician · Langhorne, PA · NPI 1093771271
  NPD (past)
• Trinity Health Mid-Atlantic Medical Group Family Medicine Physician · Holland, PA · NPI 1144521444
  NPD (past)
• Trinity Health Mid-Atlantic Medical Group Cardiovascular Disease Physician · Langhorne, PA · NPI 1902165780
  NPD (past)

Hospital & facility affiliations 1

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

• St Mary Medical Center General Acute Care Hospital · Langhorne, PA · NPI 1780686931
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Health Mid-Atlantic Medical Group (350 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary Medical Center Hospital · Langhorne, PA · CCN 390258

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

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: malicea2007290@direct.trinity-health.org

Specialties & licenses

Addresses

Other identifiers

Other names

• Myrna I Alicea-Macalindong Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 10, 2018.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1619099397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 UNIVERSITY DR",
            "address_2": "SUITE 300",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401873",
            "telephone_number": "215-710-7037",
            "fax_number": "215-710-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 LANGHORNE NEWTOWN RD",
            "address_2": "SUITE 320",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "19047",
            "telephone_number": "215-750-7818",
            "fax_number": "215-752-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALICEA",
        "first_name": "MYRNA",
        "middle_name": "I",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP009402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025050510002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PA",
            "identifier": "9004062",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7675993",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01417918",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP STATE LICENSE",
            "identifier": "SP009402",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE FIRST",
            "identifier": "30221870",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "3114453",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "RN526618L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRNA",
            "last_name": "ALICEA-MACALINDONG",
            "middle_name": "I",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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