Abdul Tejan Cole

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP026961 Issued in PA

Practice address

4200 Monument Rd
Philadelphia, PA 19131-1625

Phone

(215) 929-8829

NPI assigned

Jan 20, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: atejancole3714877@nychhc.direct-ci.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Attentive Health Care LLC

  • Home Health Agency
  • Sharon Hill, PA
  • NPI 1295461713

  5% Or Greater Direct Ownership Interest, Corporate Director, W-2 Managing Employee

  CMS ownership

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.

• Belmont Behavioral Hospital, LLC

  • Psychiatric Hospital
  • Philadelphia, PA
  • NPI 1629468137

  PA

  Medicare reassignment NPD
• Metropolitan Medical Practice Plan PC

  • General Practice Physician
  • New York, NY
  • NPI 1306138383

  NY

  Medicare reassignment NPD
• Attentive Health Care LLC

  • Home Health Agency
  • Sharon Hill, PA
  • NPI 1295461713
  NPD (past) Authorized official
• Belmont Behavioral Hospital, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Philadelphia, PA
  • NPI 1346621448
  NPD

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1831804103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 MONUMENT RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 MONUMENT RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311625",
            "telephone_number": "215-929-8829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "ABDUL",
        "middle_name": "TEJAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP026961",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN677631",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Colby, DDS
• Brenda Colclough
• Sydney Agnes Coldren, MD
• Kalia C. Cole-Avery, CRNP
• Jennifer Lynn Cole-Pucci, PSY.D.
• Amanda Elizabeth Cole
• Ashley Kahlil Cole, PA-C, ATC
• Danielle Cole, MA
• Emily Ann Cole
• Frances Josephine Cole, PHD

• All providers in Philadelphia, PA
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.