Individual provider Active NPI

Alexander John Siomko, CRNP

  • Adult Health Nurse Practitioner
  • Elkins Park, PA
National Provider Identifier
1922296987
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP00649C Issued in PA
Practice address
8080 Old York Rd
Suite 204
Elkins Park, PA 19027-1421
Phone
(215) 635-3151
Fax
(215) 635-3165
NPI assigned
Oct 4, 2007
Last updated
Oct 4, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP00649C PA Primary

Addresses

Primary practice location

8080 Old York Rd
Suite 204
Elkins Park, PA 19027-1421

Mailing address

8080 Old York Road
Suite 204
Elkins Park, PA 19027-1426
Phone (215) 635-3151

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
I20071024000242 PA Practitioner - Nurse Practitioner 0345337234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Homecare LLCGroup PAC ID 3274437462, 7 clinicians

Practice addresses (Care Compare)

8118 Old York Rd
Suite D
Elkins Park, PA 19027-1423
Phone (215) 635-3151

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP00649CPAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Homecare, LLC CurrentSince Oct 1, 2007 Accepting new patients

Locations

2480 Durham Rd
Bristol, PA 19007
Phone (215) 949-3200

8080 Old York Rd
Ste 204
Elkins Park, PA 19027
Phone (215) 635-3151

8118 Old York Rd
Ste D
Elkins Park, PA 19027
Phone (215) 635-1800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1922296987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 OLD YORK ROAD",
            "address_2": "SUITE 204",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271426",
            "telephone_number": "215-635-3151",
            "fax_number": "215-635-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 OLD YORK RD",
            "address_2": "SUITE 204",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271421",
            "telephone_number": "215-635-3151",
            "fax_number": "215-635-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIOMKO",
        "first_name": "ALEXANDER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP00649C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins Park, PA

Sources for this page

Verify at the official NPI Registry.