Individual provider Active NPI

Danielle Iezzi

  • Primary Care Nurse Practitioner
  • West Chester, PA
National Provider Identifier
1710709290
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
SP031038 Issued in PA
Practice address
440 E Marshall St
West Chester, PA 19380-5414
Phone
(215) 316-5151
NPI assigned
Oct 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X SP031038 PA Primary

Addresses

Primary practice location

440 E Marshall St
West Chester, PA 19380-5414

Mailing address

842 Blythe Ave
Drexel Hill, PA 19020

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
I20250205002741 PA Practitioner - Nurse Practitioner 4981134954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 615-5858

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP031038PAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Dec 2, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Dec 2, 2024 Accepting new patients

Locations

3400 Civic Center Blvd
#2
Philadelphia, PA 19104
Phone (215) 615-0063

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

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": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1710709290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 BLYTHE AVE",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "19020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E MARSHALL ST",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193805414",
            "telephone_number": "215-316-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IEZZI",
        "first_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP031038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.