Individual provider Active NPI

Tetyana Demkovych, CRNP

  • Family Nurse Practitioner
  • Jenkintown, PA
National Provider Identifier
1659812675
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017058 Issued in PA
Practice address
1515 Fairway
Jenkintown, PA 19046-1435
Phone
(267) 255-4838
NPI assigned
Mar 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP017058 PA Primary

Addresses

Primary practice location

1515 Fairway
Jenkintown, PA 19046-1435

Mailing address

1515 The Fairway
Jenkintown, PA 19046-1435
Phone (267) 255-4838

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
I20170426001069 PA Practitioner - Nurse Practitioner 2264719418 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Humangood PennsylvaniaGroup PAC ID 3577559038, 3 clinicians

Practice addresses (Care Compare)

1515 The Fairway
Rydal, PA 19046-1435
Phone (215) 885-8600

Hospital & facility affiliations

  • Rydal Park of Philadelphia Presbytery Homes, Inc Nursing home, Rydal, PA, CCN 395321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP017058PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physicians Inc. CurrentSince Jun 15, 2017 Accepting new patients
Temple Physician Inc. CurrentSince Jun 15, 2017 Accepting new patients
Humangood Pennsylvania CurrentSince Mar 14, 2025 Accepting new patients
Temple Physicians Inc Current Accepting new patients

Locations

1900 Huntington Dr
Duarte, CA 91010
Phone (925) 924-7100

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1659812675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 THE FAIRWAY",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190461435",
            "telephone_number": "267-255-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 FAIRWAY",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190461435",
            "telephone_number": "267-255-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMKOVYCH",
        "first_name": "TETYANA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenkintown, PA

Sources for this page

Verify at the official NPI Registry.