Elisa Blum
Individual provider Active NPI Nurse Practitioner · Philadelphia, PA
NPI 1720464530 · NPPES record last updated Aug 4, 2015
Key facts
- NPI
- 1720464530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- SP014709 (PA)
- Practice address
- 3400 Spruce St
1 Silverstein, Suite 110
Philadelphia, PA 19104-4238 - Phone
- (215) 662-2277
- NPI assigned
- Aug 4, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lancaster General Medical Group
Practice addresses (Care Compare)
2102 Harrisburg Pike
Lancaster, PA 17601-2644
Phone (717) 544-9400
Hospital & facility affiliations
- Lancaster General Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151019001639 | PA | Practitioner - Nurse Practitioner | 0244549087 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lancaster General Medical Group | Current | Accepting new patients | |
| University of Penn-Medical Group | Current |
Accepting new patients | |
| HCR Manorcare Medical Services of Florida LLC | Nurse Practitioner | Current |
Accepting new patients |
| University of Penn-Medical Group | Current |
Accepting new patients | |
| Lancaster General Medical Group | Current |
Accepting new patients | |
| University of Penn-Medical Group | Current | Accepting new patients | |
| Lancaster General Medical Group | Current |
Accepting new patients | |
| Lancaster General Medical Group | Past | Accepting new patients |
Locations
L2540
Columbus, OH 43260
60 Highland Rd
Bethel Park, PA 15102
Phone (412) 531-6050
2102 Harrisburg Pike
Lancaster, PA 17601
Phone (717) 544-3600
554 N Duke St
Lancaster, PA 17602
Phone (717) 291-5863
3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644
3400 Spruce St
Ste 110
Philadelphia, PA 19104
Phone (215) 662-2277
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | SP014709 | PA | Yes |
Addresses
Primary practice location
3400 Spruce St
1 Silverstein, Suite 110
Philadelphia, PA 19104-4238
Mailing address
3400 Spruce St
1 Silverstein, Suite 110
Philadelphia, PA 19104-4238
Phone (215) 662-2277
Other providers in Philadelphia, PA
- Blueford Charter School
- Bethany Blum
- Carol Ann Blum
- Christina Blum
- Cozette Landis Blum
- Marissa A Blum
- Michael D Blum
- Nathan J Blum
- Emily A Blumberg
- Melissa Blumberg
All providers in Philadelphia, PA · Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.