Individual provider Active NPI

Susan M Durkin, MS MSN CRNP

  • Nurse Practitioner
  • Wyomissing, PA
National Provider Identifier
1821134776
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
DV012851 Issued in PA
Practice address
2760 Century Blvd
Wyomissing, PA 19610-3359
Phone
(610) 375-4251
Fax
(610) 685-2870
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X DV012851 PA Primary

Addresses

Primary practice location

2760 Century Blvd
Wyomissing, PA 19610-3359

Mailing address

2760 Century Blvd
Wyomissing, PA 19610-3359
Phone (610) 375-4251

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
I20050615000561 PA Practitioner - Nurse Practitioner 5294779773 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
DV012851PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infusion Center of Berks County PC CurrentSince Jul 24, 2022 Accepting new patients

Locations

2760 Century Blvd
Ste 3
Wyomissing, PA 19610
Phone (610) 375-4251

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1821134776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 CENTURY BLVD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103359",
            "telephone_number": "610-375-4251",
            "fax_number": "610-685-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 CENTURY BLVD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103359",
            "telephone_number": "610-375-4251",
            "fax_number": "610-685-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURKIN",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MS MSN CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "DV012851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.