Individual provider Active NPI

Ashley Olivia Sufalko, CPNP

  • Pediatric Nurse Practitioner
  • Bensalem, PA
National Provider Identifier
1649612367
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP013943 Issued in PA
Practice address
2217 Bristol Pike
Bensalem, PA 19020-5720
Phone
(215) 638-0555
NPI assigned
Jul 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 658489-1 NY
Pediatric Nurse Practitioner 363LP0200X SP013943 PA Primary

Addresses

Primary practice location

2217 Bristol Pike
Bensalem, PA 19020-5720

Mailing address

16 Jarrett CT
Princeton Junction, NJ 08550-2214
Phone (609) 915-9510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160607002095 NJ Practitioner - Nurse Practitioner 6103116900 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
658489-1NYMDRegistered Nurse
SP013943PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Resource and Referral Center, Inc. CurrentSince May 1, 2016 Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince May 1, 2016 Accepting new patients
Lakewood Resource and Referral Center Inc Current Accepting new patients
True North Medical Group, LLC Past Accepting new patients
Jerome H. Horowitz, M.D.,P.C. Past Accepting new patients

Locations

1771 Madison Ave
Lakewood, NJ 08701
Phone (732) 364-2144

Interoperability endpoints

  • Direct secure messaging: ashley.sufalko@chemed.eclinicaldirectplus.com

Organizations & group practices 5

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": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1649612367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 JARRETT CT",
            "city": "PRINCETON JUNCTION",
            "state": "NJ",
            "postal_code": "085502214",
            "telephone_number": "609-915-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 BRISTOL PIKE",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190205720",
            "telephone_number": "215-638-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUFALKO",
        "first_name": "ASHLEY",
        "middle_name": "OLIVIA",
        "name_prefix": "Miss",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "658489-1",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP013943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensalem, PA

Sources for this page

Verify at the official NPI Registry.