Individual provider Active NPI

Katsiaryna Vasilyeva, CRNP

  • Family Nurse Practitioner
  • Berwyn, PA
National Provider Identifier
1659896025
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017413 Issued in PA
Practice address
1001 Chesterbrook Blvd
Berwyn, PA 19312-3805
Phone
(610) 576-7600
NPI assigned
Aug 7, 2017
Last updated
Oct 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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 SP017413 PA Primary

Addresses

Primary practice location

1001 Chesterbrook Blvd
Berwyn, PA 19312-3805

Mailing address

1001 Chesterbrook Blvd
Berwyn, PA 19312-3805
Phone (610) 576-7700

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
I20171110001739 PA Practitioner - Nurse Practitioner 4981960770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Jefferson Medical College of Thomas Jefferson University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

120 Valley Green Lane
Suite 510
King of Prussia, PA 19406
Phone (484) 324-7100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Aug 22, 2022 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

120 Valley Green Ln
Ste 510
King of Prussia, PA 19406
Phone (484) 324-7100

120 Valley Green Ln
Ste 670
King of Prussia, PA 19406
Phone (484) 324-7100

Organizations & group practices 1

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": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1659896025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CHESTERBROOK BLVD",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193123805",
            "telephone_number": "610-576-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 CHESTERBROOK BLVD",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193123805",
            "telephone_number": "610-576-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASILYEVA",
        "first_name": "KATSIARYNA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, PA

Sources for this page

Verify at the official NPI Registry.