Individual provider Active NPI

Suzanne T O'Leary, CRNP

  • Nurse Practitioner
  • Media, PA
National Provider Identifier
1699147512
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP015519 Issued in PA
Practice address
1098 W Baltimore Pike Ste 3308
Media, PA 19063-5139
Phone
(610) 565-8564
Fax
(610) 565-3046
NPI assigned
Oct 30, 2015
Last updated
Nov 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP015519 PA Primary
Acute Care Nurse Practitioner 363LA2100X SP015519 PA

Addresses

Primary practice location

1098 W Baltimore Pike Ste 3308
Media, PA 19063-5139

Mailing address

3803 W Chester Pike Ste 160
3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Phone (610) 565-8564

Other practice location 1

825 Old Lancaster Rd Ste 420
Bryn Mawr, PA 19010-3236
Phone (610) 527-4896

Other practice location 2

1088 W Baltimore Pike Ste 2202
Media, PA 19063-5136
Phone (484) 442-8235

Other names 1

  • Suzanne T Bergan Former 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
I20160105002729 PA Practitioner - Nurse Practitioner 5496057622 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
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)

1020 Baltimore Pike
Suite 220
Glen Mills, PA 19342-1372
Phone (484) 442-8235

1098 W Baltimore Pike
Media, PA 19063-5139
Phone (610) 565-8564

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP015519PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Critical Care & Sleep Physicians of the Main Line PC CurrentSince Sep 1, 2020 Accepting new patients
Bryn Mawr Medical Specialists Association CurrentSince Aug 17, 2025 Accepting new patients
Bryn Mawr Medical Specialists Association CurrentSince Jul 1, 2024 Accepting new patients

Locations

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

825 Old Lancaster Rd
Ste 320
Bryn Mawr, PA 19010
Phone (610) 524-3800

825 Old Lancaster Rd
Ste 420
Bryn Mawr, PA 19010
Phone (610) 527-4896

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

1020 Baltimore Pike
Ste 220
Glen Mills, PA 19342
Phone (484) 442-8235

1088 W Baltimore Pike
Ste 2202
Media, PA 19063
Phone (484) 442-8235

1098 W Baltimore Pike
Ste 3402
Media, PA 19063
Phone (610) 565-3250

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

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.

Hospital & facility affiliations 4

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": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1699147512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "address_2": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "610-565-8564",
            "fax_number": "610-565-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 W BALTIMORE PIKE STE 3308",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635139",
            "telephone_number": "610-565-8564",
            "fax_number": "610-565-3046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Old Lancaster Rd Ste 420",
            "address_purpose": "LOCATION",
            "city": "Bryn Mawr",
            "state": "PA",
            "postal_code": "190103236",
            "country_code": "US",
            "telephone_number": "610-527-4896",
            "fax_number": "610-525-4089",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1088 W Baltimore Pike Ste 2202",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "190635136",
            "country_code": "US",
            "telephone_number": "484-442-8235",
            "fax_number": "484-443-8039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'LEARY",
        "first_name": "SUZANNE",
        "middle_name": "T",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP015519",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP015519",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "BERGAN",
            "middle_name": "T",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.