Individual provider Active NPI

Patrick Ciak-Linton, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1699559211
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP028044 Issued in PA
Practice address
408 E Woodlawn St
Philadelphia, PA 19144-1333
Phone
(609) 314-1189
NPI assigned
Aug 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP028044 PA Primary

Addresses

Primary practice location

408 E Woodlawn St
Philadelphia, PA 19144-1333

Mailing address

408 E Woodlawn St
Philadelphia, PA 19144-1333
Phone (609) 314-1189

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
I20231212000175 PA Practitioner - Nurse Practitioner 8426407867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP028044PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Wound Care of Pennsylvania LLC CurrentSince Nov 4, 2023 Accepting new patients

Locations

1481 McDonald Ave
Brooklyn, NY 11230
Phone (347) 479-1110

1104 Welsh Rd
Philadelphia, PA 19115
Phone (215) 676-7191

Organizations & group practices 1

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": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1699559211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E WOODLAWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191441333",
            "telephone_number": "609-314-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E WOODLAWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191441333",
            "telephone_number": "609-314-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIAK-LINTON",
        "first_name": "PATRICK",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP028044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.