Active NPI
Beth Ann Boruta, RN MSN CRNP
- Nurse Practitioner
- Philadelphia, PA
National Provider Identifier
1851654362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- TP-003200-U
- Practice address
- 3400 Spruce St
Philadelphia, PA 19104-4206 - Phone
- (215) 662-4000
- NPI assigned
- Jun 19, 2012
- Last updated
- Jun 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | TP-003200-U | PA | Primary |
Addresses
Primary practice location
3400 Spruce St
Philadelphia, PA 19104-4206
Mailing address
13 Millers Rd
Newtown, PA 18940-4207
Phone (267) 254-3021
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TP-003200-U | PA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340064000000",
"number": "1851654362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 MILLERS RD",
"city": "NEWTOWN",
"state": "PA",
"postal_code": "189404207",
"telephone_number": "267-254-3021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044206",
"telephone_number": "215-662-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORUTA",
"first_name": "BETH",
"middle_name": "ANN",
"credential": "RN MSN CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-19",
"last_updated": "2012-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "TP-003200-U",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.