Nicole Renee Fanelli, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN584593 Issued in PA

Practice address

3400 Civic Center Blvd
Philadelphia, PA 19104-5127

Phone

(215) 349-8310

Fax

(215) 662-2739

NPI assigned

Oct 17, 2014

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

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Anesthesia Services PCGroup PAC ID 3173437613, 437 clinicians

University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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 and National Provider Directory roles.

• University of Penn-Medical Group

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1235527342
  Medicare reassignment Care Compare group NPD
• United Anesthesia Services PC

  • Anesthesiology Physician
  • Wynnewood, PA
  • NPI 1053366062
  Medicare reassignment Care Compare group
• University of Penn-Medical Group

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1609264720
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD

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

• Presbyterian Medical Center of the University of Pennsylvania Health S

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1245207521
  Care Compare affiliation

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1790189926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-349-8310",
            "fax_number": "215-662-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-349-8310",
            "fax_number": "215-662-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANELLI",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN584593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackie Fane, M.D.
• Kathleen Elissa Fane, M.D.
• Jeffrey Faneck, PHARMD
• Andrea Fanelli, NP
• Elaine Fanelli, CRNP
• John Michael Fanelly, DPM
• Jianhua Fang, HTL (ASCP)
• Michele Min-I Fang, MD
• Saige Xueqi Fang, AGPCNP-BC
• Victoria Fang, MD, PHD

• Certified Registered Nurse Anesthetist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Certified Registered Nurse Anesthetist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.