Individual provider Active NPI

Eileen Rothrock, NP

  • Nurse Practitioner
  • Huntingdon Valley, PA
National Provider Identifier
1659440550
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
VP006491C Issued in PA
Practice address
3430 Huntingdon Pike
Huntingdon Valley, PA 19006
Phone
(215) 938-7171
Fax
(215) 938-7338
NPI assigned
Nov 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 VP006491C PA Primary

Addresses

Primary practice location

3430 Huntingdon Pike
Huntingdon Valley, PA 19006

Mailing address

350 Crabtree Dr
Levittown, PA 19007
Phone (215) 547-1871

Other identifiers 1

IdentifierTypeStateIssuer
R01817831OtherPABLUE SHIELD

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
I20040804001439 PA Practitioner - Nurse Practitioner 9931170743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

40 W Frack St
Frackville, PA 17931-1719
Phone (570) 794-6123

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
VP006491CPAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Coordinated Health Care, LLC CurrentSince Sep 15, 2016 Accepting new patients
Cornerstone Coordinated Health Care, LLC CurrentSince Sep 15, 2016 Accepting new patients

Locations

40 W Frack St
Frackville, PA 17931
Phone (570) 794-6123

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659440550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 CRABTREE DR",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "19007",
            "telephone_number": "215-547-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 HUNTINGDON PIKE",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "19006",
            "telephone_number": "215-938-7171",
            "fax_number": "215-938-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHROCK",
        "first_name": "EILEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "VP006491C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "R01817831",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon Valley, PA

Sources for this page

Verify at the official NPI Registry.