Individual provider Active NPI

Stephanie Kochersperger, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ambler, PA
National Provider Identifier
1639811193
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP025535 Issued in PA
Practice address
156 S Bethlehem Pike
Ambler, PA 19002-5821
Phone
(215) 767-7096
NPI assigned
Apr 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP025535 PA Primary

Addresses

Primary practice location

156 S Bethlehem Pike
Ambler, PA 19002-5821

Mailing address

2333 Kenderton Ave
Abington, PA 19001-2432
Phone (215) 817-7946

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
I20241217000643 PA Practitioner - Nurse Practitioner 7719414622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Behavioral Care of Connecticut PCGroup PAC ID 9436502879, 132 clinicians

Practice addresses (Care Compare)

309 N Sumneytown Pike
North Wales, PA 19454-2505
Phone (215) 767-7096

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Oct 11, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Oct 11, 2024 Accepting new patients

Locations

156 S Bethlehem Pike
Ambler, PA 19002
Phone (215) 767-7096

309 N Sumneytown Pike
North Wales, PA 19454
Phone (215) 767-7096

7 Neshaminy Interplex Dr
Trevose, PA 19053

7 Neshaminy Interplex Dr
Ste 411
Trevose, PA 19053

Interoperability endpoints

  • Direct secure messaging: stephanie.kochersperger.1@28623.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1639811193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 KENDERTON AVE",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190012432",
            "telephone_number": "215-817-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 S BETHLEHEM PIKE",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190025821",
            "telephone_number": "215-767-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHERSPERGER",
        "first_name": "STEPHANIE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP025535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ambler, PA

Sources for this page

Verify at the official NPI Registry.