Individual provider Active NPI

Murielle Marie Jeanty, CRNP

  • Gerontology Nurse Practitioner
  • Willow Grove, PA
National Provider Identifier
1669185443
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP026648 Issued in PA
Practice address
735 Fitzwatertown Rd Ste 1
Willow Grove, PA 19090-1338
Phone
(215) 657-2012
Fax
(215) 657-2018
NPI assigned
Dec 27, 2022
Last updated
Dec 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP026648 PA Primary

Addresses

Primary practice location

735 Fitzwatertown Rd Ste 1
Willow Grove, PA 19090-1338

Mailing address

122 S Timber Rd
Holland, PA 18966-2858
Phone (215) 657-2012

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
I20230131000310 PA Practitioner - Nurse Practitioner 6305217381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Jefferson Medical College of Thomas Jefferson University, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

1200 W Tabor Rd
Moss 4TH FL
Philadelphia, PA 19141-3019
Phone (215) 456-3815

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP026648PAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Aug 1, 2024 Accepting new patients
Einstein Practice Plan Inc CurrentSince Aug 1, 2024 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

1200 W Tabor Rd
Fl 4
Philadelphia, PA 19141
Phone (215) 456-3815

235 W Chelten Ave
Philadelphia, PA 19144
Phone (215) 844-0637

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

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

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, 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": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1669185443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S TIMBER RD",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189662858",
            "telephone_number": "215-657-2012",
            "fax_number": "215-657-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 FITZWATERTOWN RD STE 1",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901338",
            "telephone_number": "215-657-2012",
            "fax_number": "215-657-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANTY",
        "first_name": "MURIELLE",
        "middle_name": "MARIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP026648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Grove, PA

Sources for this page

Verify at the official NPI Registry.