Individual provider Active NPI

Dyllan Joan Walter, C.R.N.P.

  • Family Nurse Practitioner
  • Chalfont, PA
National Provider Identifier
1780915090
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP010278 Issued in PA
Practice address
1600 Horizon Dr Ste 117
Chalfont, PA 18914-4100
Phone
(215) 997-9737
Fax
(215) 997-9738
NPI assigned
Jan 26, 2010
Last updated
Oct 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP010278 PA Primary

Addresses

Primary practice location

1600 Horizon Dr Ste 117
Chalfont, PA 18914-4100

Mailing address

2500 Maryland Rd Ste 400
Willow Grove, PA 19090-1225
Phone (215) 481-4143

Other identifiers 1

IdentifierTypeStateIssuer
1024978654MedicaidPA

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
I20100429000293 PA Practitioner - Nurse Practitioner 5597892281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

101 E Olney Ave
Philadelphia, PA 19120-2470
Phone (215) 927-1937

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP010278PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Community Health Associates, Inc CurrentSince Dec 15, 2024 Accepting new patients
Einstein Community Health Associates, Inc CurrentSince Dec 15, 2024 Accepting new patients

Locations

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

1600 Horizon Dr
Ste 117
Chalfont, PA 18914
Phone (215) 368-4434

500 York Rd
Ste 108
Jenkintown, PA 19046
Phone (215) 481-2725

101 E Olney Ave
Ste C5
Philadelphia, PA 19120
Phone (215) 927-1937

Organizations & group practices 2

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 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": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1780915090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MARYLAND RD STE 400",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901225",
            "telephone_number": "215-481-4143",
            "fax_number": "215-481-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HORIZON DR STE 117",
            "city": "CHALFONT",
            "state": "PA",
            "postal_code": "189144100",
            "telephone_number": "215-997-9737",
            "fax_number": "215-997-9738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "DYLLAN",
        "middle_name": "JOAN",
        "name_prefix": "Mrs.",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP010278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024978654",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chalfont, PA

Sources for this page

Verify at the official NPI Registry.