Individual provider Active NPI

Selva Sunil Samuel, DNP, CRNP, RN

  • Family Nurse Practitioner
  • Langhorne, PA
National Provider Identifier
1790476125
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP026627 Issued in PA
Practice address
825 Town Center Dr Ste 152
Langhorne, PA 19047-1793
Phone
(215) 741-3510
NPI assigned
May 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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 SP026627 PA Primary

Addresses

Primary practice location

825 Town Center Dr Ste 152
Langhorne, PA 19047-1793

Mailing address

18 Rocking Horse Way
Southampton, PA 18966-2561
Phone (215) 317-6665

Other names 1

  • Selva Koruth Former name

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
I20230831004020 PA Practitioner - Nurse Practitioner 6709249154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
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)

201 Gibraltar Rd
Suite 120
Horsham, PA 19044-2331
Phone (215) 706-2034

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Cancer Specialists CurrentSince Jan 6, 2025 Accepting new 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 Jan 6, 2025 Accepting new patients
Clinical Renal Associates, LLC CurrentSince Jul 17, 2023 Accepting new patients

Locations

30 Medical Center Blvd
Ste 303
Chester, PA 19013

201 Gibraltar Rd
Ste 120
Horsham, PA 19044
Phone (215) 658-7252

825 Town Center Dr
Ste 152
Langhorne, PA 19047
Phone (215) 741-3510

380 N Oxford Valley Rd
Langhorne, PA 19047
Phone (215) 949-5000

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

9910 Roosevelt Blvd
Philadelphia, PA 19115
Phone (215) 658-4669

8815 Germantown Ave
Ste 16
Philadelphia, PA 19118
Phone (215) 242-1159

8815 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8145

100 E Lancaster Ave
Ste B20
Wynnewood, PA 19096
Phone (610) 492-5200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3389/brand/1/csg/21/fhir/r4

Organizations & group practices 5

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.

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": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1790476125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ROCKING HORSE WAY",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189662561",
            "telephone_number": "215-317-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 TOWN CENTER DR STE 152",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471793",
            "telephone_number": "215-741-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "SELVA",
        "middle_name": "SUNIL",
        "credential": "DNP, CRNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP026627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SELVA",
            "last_name": "KORUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Langhorne, PA

Sources for this page

Verify at the official NPI Registry.