Individual provider Active NPI

Michele Anne McDonald, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1710629530
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP025349 Issued in PA
Practice address
925 Chestnut St FL 4
Philadelphia, PA 19107-4207
Phone
(610) 517-7138
NPI assigned
Apr 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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 SP025349 PA Primary

Addresses

Primary practice location

925 Chestnut St FL 4
Philadelphia, PA 19107-4207

Mailing address

925 Chestnut St FL 4
Philadelphia, PA 19107-4207
Phone (215) 955-8199

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Philadelphia Health Information Exchange (HIE)

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
I20220826002151 PA Practitioner - Nurse Practitioner 4486038346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

1101 Chestnut St
Philadelphia, PA 19107-3619
Phone (800) 533-3669

925 Chestnut St
Philadelphia, PA 19107-4204

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
  • Jefferson Abington Hospital Hospital, Abington, PA, CCN 390231

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince May 4, 2022 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

925 Chestnut St
Fl 4
Philadelphia, PA 19107
Phone (215) 955-5772

1101 Chestnut St
#8
Philadelphia, PA 19107
Phone (215) 955-5869

925 Chestnut St
Ste Mezzanine
Philadelphia, PA 19107

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

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.

Hospital & facility affiliations 3

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": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1710629530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074207",
            "telephone_number": "215-955-8199",
            "fax_number": "215-923-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074207",
            "telephone_number": "610-517-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "MICHELE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP025349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Philadelphia",
            "affiliation": "N",
            "endpointDescription": "Philadelphia",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Philadelphia",
            "address_1": "925 Chestnut St Fl 4",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191074207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.