Ansu Siryon Molley
Individual provider Active NPI Family Nurse Practitioner · Secane, PA
NPI 1891228987 · NPPES record last updated Feb 16, 2024
Key facts
- NPI
- 1891228987
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- SP017298 (PA)
- Practice address
- 649 South Ave Unit 7
Secane, PA 19018-3541 - Phone
- (610) 944-4290
- NPI assigned
- Apr 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
424 Church St
Nashville, TN 37219-2301
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA, DE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180430000673 | PA | Practitioner - Nurse Practitioner | 9234493297 | Reassigns benefits to 1 organization |
| I20251002002442 | DE | Practitioner - Nurse Practitioner | 9234493297 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP017298 | PA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Health Network LLC | Current |
Accepting new patients | |
| Molley Family Healthcare & Wellness Center LLC | Family | Current |
Accepting new patients |
Locations
1000 N West St
Ste 1200
Wilmington, DE 19801
Phone (302) 449-6471
649 South Ave
Unit 7
Secane, PA 19018
Phone (610) 944-4290
424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721
Interoperability endpoints
- ansu.molley.1@31668.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP017298 | PA | Yes |
Addresses
Primary practice location
649 South Ave Unit 7
Secane, PA 19018-3541
Mailing address
649 South Ave Unit 7
Secane, PA 19018-3541
Phone (610) 944-4290
Other providers in Secane, PA
- Mercy Management of Southeastern Pennsylvania
- James M Minnella
- Minute Care Transport LLC
- Mog International LLC
- Molley Family Healthcare & Wellness Center LLC
- Amanda Carroll Montgomery
- Cosmo Joseph Nylander
- Pally Hands Homecare LLC
- Carrie Parker
- Purva Patel
All providers in Secane, PA · Family Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.