Amy Travaline, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SPO23855 Issued in PA

Practice address

125 S 9TH St Ste 1005
Philadelphia, PA 19107-5123

Phone

(215) 543-7002

Fax

(215) 987-5891

NPI assigned

Sep 1, 2021

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

Other names 1

• Miss Amy Zawada Former name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• Koka Cardiology PC

  • Specialist
  • Philadelphia, PA
  • NPI 1528307287
  Medicare reassignment NPD
• Koka Cardiology PC

  • Internal Medicine Physician
  • Phila, PA
  • NPI 1942610274
  NPD (past)

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1790453066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S 9TH ST STE 1005",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075123",
            "telephone_number": "215-543-7002",
            "fax_number": "215-987-5891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S 9TH ST STE 1005",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075123",
            "telephone_number": "215-543-7002",
            "fax_number": "215-987-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVALINE",
        "first_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SPO23855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "ZAWADA",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffany Trat
• Kelsey Kendall Traunero, MD
• Kimberlin Trauthwein, PA-C
• Paxson A Trautman, M.D.
• Deborah Trautz Shumsky, RPH
• John Travaline, MD
• Christopher Smith Travers, MD
• Eleanor May Travers, M.D.
• Ellis Travers, CCHW
• Latifah Fatima Travis-Bey, MS

• Adult Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, 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 Sep 1, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.