Individual provider Active NPI

Nicole Elise Pacella, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Coraopolis, PA
National Provider Identifier
1669885075
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP025874 Issued in PA
Practice address
104 Marshall Dr
Coraopolis, PA 15108-2704
Phone
(412) 888-9344
NPI assigned
Jun 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN616173 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP025874 PA Primary

Addresses

Primary practice location

104 Marshall Dr
Coraopolis, PA 15108-2704

Mailing address

104 Marshall Dr
Coraopolis, PA 15108-2704
Phone (412) 888-9344

Other identifiers 2

IdentifierTypeStateIssuer
SP025874OtherPAPSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER
RN616173OtherPAREGISTERED NURSE

Other names 1

  • Nicole Elise Pacella Professional name

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
I20220921000296 PA Practitioner - Nurse Practitioner 9436534872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Care of Pennsylvania LLCGroup PAC ID 0143521211, 91 clinicians

Practice addresses (Care Compare)

2109 Red Lion Rd
Philadelphia, PA 19115-1711
Phone (718) 298-4375

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN616173PAMDRegistered Nurse
SP025874PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rend Psychiatry, LLC Psychiatric/Mental Health Current Accepting new patients
Supportive Care of Pennsylvania LLC CurrentSince Jan 15, 2025 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

2109 Red Lion Rd
Philadelphia, PA 19115
Phone (215) 213-7000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1669885075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MARSHALL DR",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151082704",
            "telephone_number": "412-888-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MARSHALL DR",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151082704",
            "telephone_number": "412-888-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACELLA",
        "first_name": "NICOLE",
        "middle_name": "ELISE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN616173",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP025874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER",
            "identifier": "SP025874",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "RN616173",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "PACELLA",
            "middle_name": "ELISE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Coraopolis, PA

Sources for this page

Verify at the official NPI Registry.