Individual provider Active NPI

Mary Ellen Dagusto, CRNP

  • Adult Health Nurse Practitioner
  • Doylestown, PA
National Provider Identifier
1982765392
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP007042C Issued in PA
Practice address
595 W State St
Doylestown, PA 18901-2554
Phone
(215) 345-2200
NPI assigned
Dec 12, 2006
Last updated
Feb 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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 SP007042C PA Primary

Addresses

Primary practice location

595 W State St
Doylestown, PA 18901-2554

Mailing address

621 W Sandy Ridge Rd
Doylestown, PA 18901-2106
Phone (215) 534-3498

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
I20181005001352 PA Practitioner - Nurse Practitioner 7810298478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tohickon Internal Medicine, LLCGroup PAC ID 0042492290, 7 clinicians

Practice addresses (Care Compare)

1456 Ferry Rd
Unit 400
Doylestown, PA 18901-2391
Phone (267) 880-6350

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP007042CPAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tohickon Internal Medicine CurrentSince Sep 14, 2018 Accepting new patients

Locations

1456 Ferry Rd
Unit 400
Doylestown, PA 18901
Phone (267) 362-5157

Interoperability endpoints

  • Direct secure messaging: maryellen.dagusto@dhcp.eclinicaldirectplus.com

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 7

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1982765392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 W SANDY RIDGE RD",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012106",
            "telephone_number": "215-534-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 W STATE ST",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012554",
            "telephone_number": "215-345-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGUSTO",
        "first_name": "MARY ELLEN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP007042C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doylestown, PA

Sources for this page

Verify at the official NPI Registry.