Ann Marie Pellegrino, CRNP APRNC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP006487C Issued in PA

Practice address

255 W Lancaster Ave
Paoli, PA 19301-1763

Phone

(484) 565-1600

Fax

(610) 647-2006

NPI assigned

Dec 3, 2007

Last updated

Oct 22, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD
• Health Services of Fox Chase Cancer Center

  dba Dermatology Associates of FCCC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1144338351
  NPD (past)
• Health Services of Fox Chase Cancer Center

  dba Gynecological Oncology Associates of FCCC

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1568564821
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Main Line Hospitals, Inc.

  dba Bryn Mawr Hospital

  • General Acute Care Hospital
  • Bryn Mawr, PA
  • NPI 1508971441
  Care Compare affiliation

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1750563615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "484-565-1600",
            "fax_number": "610-647-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "484-565-1600",
            "fax_number": "610-647-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRINO",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "CRNP APRNC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP006487C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Payne, NPC
• Mark William Pearson, DC
• Pediatric Associates of Paoli, PC (Pediatric Associates of Paoli)
• Pediatric Eye Physicians & Surgeons PC
• Sandra Ellen Pellatt, DNP, CRNP
• Marissa Pena
• Christina M Penderghest, CRNP
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #00399)
• Pennsylvania Physicians Services, LLC
• Michael Perez, DPT

• Adult Health Nurse Practitioner in Paoli, PA
• Providers in Paoli, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.