Individual provider Active NPI

Patricia M Patrick, CRNP

  • Adult Health Nurse Practitioner
  • Newtown, PA
National Provider Identifier
1740217835
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
VP003456P Issued in PA
Practice address
11 Friends LN
Suite 103
Newtown, PA 18940-1885
Phone
(215) 741-5600
Fax
(215) 702-9331
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X VP003456P PA Primary

Addresses

Primary practice location

11 Friends LN
Suite 103
Newtown, PA 18940-1885

Mailing address

104 Pheasant Run
Suite 128
Newtown, PA 18940-3439
Phone (215) 860-3344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040414001360 PA Practitioner - Nurse Practitioner 8628062288
I20210112000272 NJ Practitioner - Nurse Practitioner 8628062288 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Service Fund of Deborah Heart and Lung CenterGroup PAC ID 4284537499, 118 clinicians
Deborah Cardiovascular Group, P.C.Group PAC ID 7618962549, 40 clinicians

Practice addresses (Care Compare)

200 Trenton Rd
Browns Mills, NJ 08015-1705
Phone (609) 893-6611

Hospital & facility affiliations

  • Deborah Heart and Lung Center Hospital, Browns Mills, NJ, CCN 310031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
VP003456PPAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deborah Cardiovascular Group, P.C. CurrentSince Apr 1, 2025 Accepting new patients
Professional Service Fund of Deborah Heart & Lung Center CurrentSince Oct 19, 2020 Accepting new patients
Professional Service Fund of Deborah- Anesthesia Current Accepting new patients
Pennsylvania Heart and Vascular Group, P.C. Past Accepting new patients

Locations

200 Trenton Rd
Browns Mills, NJ 08015
Phone (609) 893-1200

415 Chris Gaupp Dr
Ste C
Galloway, NJ 08205
Phone (609) 748-7574

599 Route 37 W
Toms River, NJ 08755
Phone (732) 269-1133

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11366/brand/2/csg/1/fhir/r4

Organizations & group practices 4

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 1

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1740217835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 PHEASANT RUN",
            "address_2": "SUITE 128",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189403439",
            "telephone_number": "215-860-3344",
            "fax_number": "215-860-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 FRIENDS LN",
            "address_2": "SUITE 103",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401885",
            "telephone_number": "215-741-5600",
            "fax_number": "215-702-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "VP003456P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, PA

Sources for this page

Verify at the official NPI Registry.