Individual provider Active NPI

Ilina Mai, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1851255715
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP034238 Issued in PA
Practice address
1801 N Broad St
Philadelphia, PA 19122-6003
Phone
(215) 204-7000
NPI assigned
Dec 15, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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 SP034238 PA Primary

Addresses

Primary practice location

1801 N Broad St
Philadelphia, PA 19122-6003

Mailing address

1801 N Broad St
Philadelphia, PA 19122-6003

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
I20260602003977 PA Practitioner - Nurse Practitioner 1254802069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

302 Segel Dr
Media, PA 19063-2158

423 W Shunk St
Philadelphia, PA 19148-4640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP034238PAMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1765756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1851255715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191226003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191226003",
            "telephone_number": "215-204-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "ILINA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-12-15",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP034238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.