Donna M Mortimer, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA051640 Issued in PA

Practice address

23 Bustleton Pike Ste 100
Feasterville Trevose, PA 19053-6446

Phone

(215) 464-9599

Fax

(215) 464-7865

NPI assigned

Sep 21, 2005

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Premier Immediate Medical Care, LLC

  • Urgent Care Clinic/Center
  • Exton, PA
  • NPI 1821040890
  NPD (past)

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1841286317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12265 TOWNSEND RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191541201",
            "telephone_number": "215-856-1010",
            "fax_number": "215-856-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 BUSTLETON PIKE STE 100",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190536446",
            "telephone_number": "215-464-9599",
            "fax_number": "215-464-7865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTIMER",
        "first_name": "DONNA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-21",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "MA051640",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Afua Mintah, M.D.
• Miracle Dental Center
• Carlos Moreno, MD
• Lana M Morgovsky, RN
• Gladys Escobar Morrissey, PA-C
• Mullen Chiropractic Neurology
• Mark Jay Mullen, MD
• Kathleen Teresa Murray, CRNP
• My Child'S Therapy, Inc
• Roksolana Mykhlyk, DPT

• Medical Physician Assistant in Feasterville Trevose, PA
• Providers in Feasterville Trevose, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.