Individual provider Active NPI

Tina L Powell, CRNP

  • Adult Health Nurse Practitioner
  • Ridley Park, PA
National Provider Identifier
1770509028
Registry record updated Sep 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP008637 Issued in PA
Practice address
33 W Chester Pike
Ridley Park, PA 19078-2035
Phone
(610) 521-2012
Fax
(610) 521-3753
NPI assigned
Jul 13, 2006
Last updated
Sep 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 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 SP008637 PA Primary

Addresses

Primary practice location

33 W Chester Pike
Ridley Park, PA 19078-2035

Mailing address

3998 Red Lion Rd
Ste 130
Philadelphia, PA 19114-1443
Phone (610) 521-2010

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
I20060123000694 PA Practitioner - Nurse Practitioner 4082638507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Cancer Specialists P.C.Group PAC ID 7214194091, 44 clinicians

Practice addresses (Care Compare)

33 W Chester Pike
Ridley Park, PA 19078-2035
Phone (610) 521-2010

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP008637PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Phila Cancer & Hematology Specialists PC Current Accepting new patients
Hematology-Oncology Group, P.C. Current Accepting new patients
Alliance Cancer Specialists P.C. CurrentSince Jun 23, 2014 Accepting new patients
Alliance Cancer Specialists CurrentSince Jun 23, 2014 Accepting new patients

Locations

30 Medical Center Blvd
Ste 206
Chester, PA 19013
Phone (610) 876-5166

1203 Langhorne Newtown Rd
Ste 135
Langhorne, PA 19047
Phone (215) 612-5250

1078 W Baltimore Pike
Ste 1
Media, PA 19063
Phone (610) 565-2355

3998 Red Lion Rd
Ste 130
Philadelphia, PA 19114
Phone (215) 612-5250

33 W Chester Pike
Ridley Park, PA 19078
Phone (610) 521-2010

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1770509028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 RED LION RD",
            "address_2": "STE 130",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141443",
            "telephone_number": "610-521-2010",
            "fax_number": "610-521-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W CHESTER PIKE",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782035",
            "telephone_number": "610-521-2012",
            "fax_number": "610-521-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "TINA",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP008637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridley Park, PA

Sources for this page

Verify at the official NPI Registry.