Individual provider Active NPI

Mariya Zvyagelsky, CRNP

  • Gerontology Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1972352466
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP029767 Issued in PA
Practice address
10160 Bustleton Ave Ste a
Philadelphia, PA 19116-3749
Phone
(215) 671-3920
NPI assigned
May 16, 2024
Last updated
May 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP029767 PA Primary

Addresses

Primary practice location

10160 Bustleton Ave Ste a
Philadelphia, PA 19116-3749

Mailing address

459 Bridgetown Pike
Langhorne, PA 19053-7210
Phone (267) 575-0922

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
I20240711000891 PA Practitioner - Nurse Practitioner 6709321029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Jefferson Medical College of Thomas Jefferson University, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

10160 Bustleton Ave
Suite a
Philadelphia, PA 19116-3749
Phone (215) 750-6566

240 Middletown Blvd
Langhorne, PA 19047-1832

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physician Services CurrentSince Jun 1, 2024 Accepting new patients
Aria Health Physician Services CurrentSince Jun 1, 2024 Accepting new patients
Aria Health Physician Services Current Accepting new patients
Aria Health Physician Services Past Accepting new patients

Locations

240 Middletown Blvd
Ste 101C
Langhorne, PA 19047
Phone (215) 550-9999

10160 Bustleton Ave
Ste A
Philadelphia, PA 19116
Phone (215) 364-0777

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1972352466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 BRIDGETOWN PIKE",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190537210",
            "telephone_number": "267-575-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10160 BUSTLETON AVE STE A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163749",
            "telephone_number": "215-671-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZVYAGELSKY",
        "first_name": "MARIYA",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP029767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.