Individual provider Active NPI

Anna Psillos, CRNP

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1649669508
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP014068 Issued in PA
Practice address
5501 Old York Rd
Korman Building-Suite 202
Philadelphia, PA 19141-3018
Phone
(215) 254-2612
Fax
(215) 456-7512
NPI assigned
Jan 15, 2015
Last updated
Jun 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP014068 PA Primary

Addresses

Primary practice location

5501 Old York Rd
Korman Building-Suite 202
Philadelphia, PA 19141-3018

Mailing address

5501 Old York Rd
Klein BLDG-331
Philadelphia, PA 19141-3018
Phone (215) 456-8608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150401001514 PA Practitioner - Nurse Practitioner 9436476439 Reassigns benefits to 2 organizations
I20191219001458 NJ Practitioner - Nurse Practitioner 9436476439 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP014068PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Wound Care New Jersey CurrentSince Jul 15, 2023 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jan 20, 2015 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jan 20, 2015 Accepting new patients
Integrated Wound Care Pennsylvania PLLC CurrentSince Oct 1, 2022 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

350 Oxford Rd
Oxford, NJ 07863
Phone (908) 453-7700

492C Cedar Ln
Teaneck, NJ 07666
Phone (201) 357-5468

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

8556 Bustleton Ave
Philadelphia, PA 19152
Phone (215) 333-3500

5501 York Rd
Ste 202
Philadelphia, PA 19141
Phone (215) 254-2630

4400 W Girard Ave
Philadelphia, PA 19104
Phone (215) 477-1170

Interoperability endpoints

  • Direct secure messaging: anna.psillos@direct.einstein.edu

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1649669508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "KLEIN BLDG-331",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-8608",
            "fax_number": "215-456-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "KORMAN BUILDING-SUITE 202",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-254-2612",
            "fax_number": "215-456-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PSILLOS",
        "first_name": "ANNA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP014068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.