Individual provider Active NPI

Therese Yoneko Parker

  • Primary Care Nurse Practitioner
  • Trevose, PA
National Provider Identifier
1942555636
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
SP014459 Issued in PA
Practice address
669 E Myrtle Ave
Trevose, PA 19053-4640
Phone
(215) 364-8412
Fax
(215) 364-8730
NPI assigned
Jul 18, 2012
Last updated
Nov 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP012416 PA
Primary Care Nurse Practitioner 363LP2300X SP014459 PA Primary
Registered Nurse 163W00000X RN628890 PA

Addresses

Primary practice location

669 E Myrtle Ave
Trevose, PA 19053-4640

Mailing address

669 E Myrtle Ave
Trevose, PA 19053-4640
Phone (215) 364-8412

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
I20121119000071 PA Practitioner - Nurse Practitioner 0547411670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd 2ND FLR W
Advanced Internal Med
Philadelphia, PA 19104-5127
Phone (215) 615-5252

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN628890PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince May 9, 2025 Accepting new patients
Primary Homecare, LLC Primary Care CurrentSince Jan 4, 2025 Accepting new patients
University of Penn-Medical Group CurrentSince May 9, 2025 Accepting new patients

Locations

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

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

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

Organizations & group practices 3

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 2

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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1942555636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 E MYRTLE AVE",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190534640",
            "telephone_number": "215-364-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 E MYRTLE AVE",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190534640",
            "telephone_number": "215-364-8412",
            "fax_number": "215-364-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "THERESE",
        "middle_name": "YONEKO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP012416",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP014459",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN628890",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trevose, PA

Sources for this page

Verify at the official NPI Registry.