Mallory Boyle, CRNP, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP027836 Issued in PA

Practice address

822 Pine St
Philadelphia, PA 19107-6187

Phone

(267) 519-0154

NPI assigned

Jan 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Schweiger Dermatology PCGroup PAC ID 0143442806, 180 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Schweiger Dermatology, PC

  • Dermatology Physician
  • Elmer, NJ
  • NPI 1104229392
  Medicare reassignment Care Compare group NPD
• Pennsylvania Centre for Dermatology, LLC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1861501801
  NPD (past)

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1669187902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 VIRGINIA AVE",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082316",
            "telephone_number": "856-904-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 PINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076187",
            "telephone_number": "267-519-0154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Civic Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "215-590-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "MALLORY",
        "credential": "CRNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR22832300",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN685967",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP027836",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01457800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jieun Boyle
• John M Boyle, MD
• John T Boyle, M.D.
• Lara Marie Boyle, MD, PHD
• Lauren E Boyle, PA-C
• Michele Rocco Boyle, PA C
• Patrick Boyle, DO
• Shannon Boyle
• Simone Boyle
• Suzanne M Boyle, MD

• Family Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.