Individual provider Active NPI

Heena Rathod, CRNP

  • Pediatric Nurse Practitioner
  • West Reading, PA
National Provider Identifier
1932528189
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP013119 Issued in PA
Practice address
655 Walnut St
West Reading, PA 19611-1242
Phone
(610) 372-9222
Fax
(610) 372-0232
NPI assigned
Apr 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X SP013119 PA Primary

Addresses

Primary practice location

655 Walnut St
West Reading, PA 19611-1242

Mailing address

655 Walnut St
West Reading, PA 19611-1242
Phone (610) 372-9222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20190306000042 NJ Practitioner - Nurse Practitioner 2264708148 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP013119PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC CurrentSince Jan 15, 2019 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Jan 15, 2019 Accepting new patients
Public Health Mangement Corporation Past Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

38 Meadowlands Pkwy
Ste 205
Secaucus, NJ 07094
Phone (201) 552-2357

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

Interoperability endpoints

  • Direct secure messaging: heenarathod@nncc.allscriptsdirect.net
  • Direct secure messaging: heena.rathod@lbp.eclinicaldirectplus.com
  • Direct secure messaging: hrathod579468@direct.ochin.org

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1932528189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 WALNUT ST",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196111242",
            "telephone_number": "610-372-9222",
            "fax_number": "610-372-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 WALNUT ST",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196111242",
            "telephone_number": "610-372-9222",
            "fax_number": "610-372-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHOD",
        "first_name": "HEENA",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP013119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Reading, PA

Sources for this page

Verify at the official NPI Registry.