Individual provider Active NPI

Alis K Panzera, CRNP

  • Adult Health Nurse Practitioner
  • Newtown Square, PA
National Provider Identifier
1689892333
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP007092 Issued in PA
Practice address
123 Ridgefield Rd
Newtown Square, PA 19073-3812
Phone
(610) 353-4391
Fax
(610) 356-2730
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP007092 PA Primary

Addresses

Primary practice location

123 Ridgefield Rd
Newtown Square, PA 19073-3812

Mailing address

897 Heritage Rd
Moorestown, NJ 08057-1329
Phone (856) 727-0653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Physician Associates of South Jersey LLC Past Accepting new patients
Continence Specialists, LLC Adult Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alis.panzera.p11@direct.ppncsnj.nextgenshare.com
  • Direct secure messaging: alis.panzera.p3@direct.ppncsnj.nextgenshare.com

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689892333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "897 HERITAGE RD",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080571329",
            "telephone_number": "856-727-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 RIDGEFIELD RD",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190733812",
            "telephone_number": "610-353-4391",
            "fax_number": "610-356-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANZERA",
        "first_name": "ALIS",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP007092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown Square, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.