Individual provider Active NPI

Nicole Cavaliere, CRNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1881130920
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP016922 Issued in PA
Practice address
111 S 11TH St Ste G8490
Philadelphia, PA 19107
Phone
(215) 955-1120
NPI assigned
Jan 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP016922 PA Primary

Addresses

Primary practice location

111 S 11TH St Ste G8490
Philadelphia, PA 19107

Mailing address

111 S 11TH St Ste G8490
Philadelphia, PA 19107-4824
Phone (215) 955-1120

Other practice location 1

900 Walnut St
Philadelphia, PA 19107
Phone (215) 955-6161

Other practice location 2

3509 N Broad St
Philadelphia, PA 19140-4105
Phone (215) 707-8484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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

Enrollment IDStateProvider typePAC IDDetails
I20170223000232 PA Practitioner - Nurse Practitioner 3971887704 Reassigns benefits to 1 organization
I20200123003070 NJ Practitioner - Nurse Practitioner 3971887704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

111 S 11TH St
Suite 8490
Philadelphia, PA 19107-4824
Phone (215) 955-6161

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Surgical Associates, PA CurrentSince Dec 11, 2019 Accepting new patients
Cooper University Trauma Physicians, PC CurrentSince Dec 11, 2019 Accepting new patients
Jefferson University Physicians CurrentSince Mar 13, 2018 Accepting new patients
Cooper Surgical Associates, PA CurrentSince Dec 11, 2019 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

900 Walnut St
Fl 2
Philadelphia, PA 19107
Phone (215) 955-1234

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

1100 Walnut St
Fl 5
Philadelphia, PA 19107
Phone (215) 955-6750

1101 Chestnut St
Fl 9
Philadelphia, PA 19107
Phone (215) 503-1807

111 S 11th St
Ste G8490
Philadelphia, PA 19107
Phone (215) 955-1120

1101 Chestnut St
Fl 17
Philadelphia, PA 19107
Phone (215) 955-5161

900 Walnut St
Philadelphia, PA 19107
Phone (215) 503-8080

925 Chestnut St
Philadelphia, PA 19107
Phone (215) 955-5050

1100 Walnut St
Ste 500
Philadelphia, PA 19107
Phone (215) 955-6750

111 S 11th St
Ste 8490
Philadelphia, PA 19107
Phone (215) 955-6161

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1881130920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST STE G8490",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-1120",
            "fax_number": "215-955-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST STE G8490",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-955-1120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19107",
            "country_code": "US",
            "telephone_number": "215-955-6161",
            "fax_number": "215-923-5507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3509 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191404105",
            "country_code": "US",
            "telephone_number": "215-707-8484",
            "fax_number": "215-707-3946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVALIERE",
        "first_name": "NICOLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP016922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.