Individual provider Active NPI

Nicole Ashley McCrary, P.A.

  • Surgical Physician Assistant
  • Wynnewood, PA
National Provider Identifier
1811231905
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA055890 Issued in PA
Practice address
100 E Lancaster Ave
Suite 330 Lankenau Mob West
Wynnewood, PA 19096-3450
Phone
(610) 645-9093
Fax
(610) 645-9476
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA055890 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
Suite 330 Lankenau Mob West
Wynnewood, PA 19096-3450

Mailing address

100 E Lancaster Ave
Suite 330 Lankenau Mob West
Wynnewood, PA 19096-3450
Phone (610) 645-9093

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
I20141210001562 PA Practitioner - Physician Assistant 2264754852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

701 E Marshall St
West Chester, PA 19380-4412

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chester County Hospital CurrentSince Mar 22, 2017 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Mar 31, 2024 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Mar 31, 2024 Accepting new patients

Locations

701 E Marshall St
West Chester, PA 19380
Phone (610) 431-5000

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

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 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": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1811231905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 330 LANKENAU MOB WEST",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-645-9093",
            "fax_number": "610-645-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 330 LANKENAU MOB WEST",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-645-9093",
            "fax_number": "610-645-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRARY",
        "first_name": "NICOLE",
        "middle_name": "ASHLEY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA055890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.