Individual provider Active NPI

Kathleen McEwen, CRNP

  • Family Nurse Practitioner
  • Monroeville, PA
National Provider Identifier
1902827454
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP004258B Issued in PA
Practice address
3893 William Penn Hwy
Monroeville, PA 15146-2127
Phone
(412) 372-2127
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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 SP004258B PA Primary

Addresses

Primary practice location

3893 William Penn Hwy
Monroeville, PA 15146-2127

Mailing address

3893 William Penn Hwy
Monroeville, PA 15146-2127
Phone (412) 372-2127

Other identifiers 1

IdentifierTypeStateIssuer
SP004258BOtherPALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE, CO, OH4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20070823000890 PA Practitioner - Nurse Practitioner 0648362491 Reassigns benefits to 2 organizations
I20231026000059 DE Practitioner - Nurse Practitioner 0648362491 Reassigns benefits to 1 organization
I20240805003894 CO Practitioner - Nurse Practitioner 0648362491 Reassigns benefits to 2 organizations
I20250218002693 OH Practitioner - Nurse Practitioner 0648362491 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP004258BPAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Complex Care of Delaware Inc CurrentSince Aug 12, 2023 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince May 16, 2024 Accepting new patients
Lighthouse Complex Care LTD CurrentSince Nov 15, 2024 Accepting new patients
Signify Health, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

14095 E Exposition Ave
Aurora, CO 80012
Phone (303) 219-0030

7700 E Arapahoe Rd
Ste 220
Centennial, CO 80112
Phone (303) 285-1148

250 Fillmore St
Unit 150
Denver, CO 80206
Phone (410) 505-0521

2500 Grubb Rd
Ste 123
Wilmington, DE 19810
Phone (302) 304-1347

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

600 N 2nd St
Ste 401
Harrisburg, PA 17101
Phone (844) 341-2339

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Interoperability endpoints

  • Direct secure messaging: kathleen.mcewen.1@30254.direct.athenahealth.com
  • Direct secure messaging: kathleen.mcewen.1@20145.direct.athenahealth.com

Organizations & group practices 4

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1902827454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3893 WILLIAM PENN HWY",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462127",
            "telephone_number": "412-372-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3893 WILLIAM PENN HWY",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462127",
            "telephone_number": "412-372-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEWEN",
        "first_name": "KATHLEEN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP004258B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "SP004258B",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.