Individual provider Active NPI

Maudeline Paul, NP

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1720749674
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP025074 Issued in PA
Practice address
1927 Penfield St
Philadelphia, PA 19138-2716
Phone
(267) 244-3944
NPI assigned
Jan 4, 2022
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP025074 PA Primary

Addresses

Primary practice location

1927 Penfield St
Philadelphia, PA 19138-2716

Mailing address

1927 Penfield St
Philadelphia, PA 19138-2716
Phone (267) 244-3944

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
I20220221001593 PA Practitioner - Nurse Practitioner 6103210919 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.2 of 100Reported as group
Quality
70
Promoting interoperability
93
Improvement activities
20
Cost
88.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP025074PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Residentialist Housecall Med GRP, PC a Pennsylvania Corp CurrentSince Feb 9, 2022 Accepting new patients
Riseabove Wellness and Care LLC Current Accepting new patients
Unlimited Gentle Care LLC Current Accepting new patients
Sayre Health Center CurrentSince Jul 11, 2022 Accepting new patients
Excel Medical Center CurrentSince Jul 11, 2023 Accepting new patients
Housecall Doctors Medical Group Inc PastSince Feb 9, 2022 Accepting new patients

Locations

3800 Kilroy Airport Way
Ste 270
Long Beach, CA 90806
Phone (949) 366-1053

208 W Chelten Ave
Philadelphia, PA 19144
Phone (215) 849-3104

4190 City Ave
Ste 528
Philadelphia, PA 19131
Phone (866) 453-8800

5800 Walnut St
Rear
Philadelphia, PA 19139
Phone (215) 474-4444

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25233/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73304
  • FHIR API: https://fhir4.healow.com/fhir/r4/CHJCDD

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1720749674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927 PENFIELD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191382716",
            "telephone_number": "267-244-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927 PENFIELD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191382716",
            "telephone_number": "267-244-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "MAUDELINE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP025074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.