MS. NICOLE DEMATTO (CRNP) – Family Nurse Practitioner, NPI 1497103790

MS. NICOLE DEMATTO (CRNP) is a healthcare provider. based in Wallingford, Pennsylvania. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. SP015744 (PA). The NPI Number for MS. NICOLE DEMATTO (CRNP) is 1497103790

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
MS. NICOLE DEMATTO (CRNP)
NPI
1497103790
Phone
(610) 675-4765
Address
204 WALLLINGFORD AVE
Enumeration Date
26 May 2016
Last Update Date
25 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4845651293
Graduation Year
2015 (11 years ago)
PAC ID
2062786403
Group Practice PAC ID
1951215201
Professional Enrollment ID
I20170922001813
Address ID
PA190083512BR1991XRDXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:10State licenses:1Digital endpointsOther names

11,473 NURSE PRACTITIONER in PA

Provider Addresses for MS. NICOLE DEMATTO (CRNP)

  • 204 WALLLINGFORD AVE

    WALLINGFORD, PA 190866134

    Phone: (610) 675-4765

    Type: Mailing

  • 1220 CHESTER PIKE

    SHARON HILL, PA 190791902

    Phone: (610) 586-2122

    Type: Location

  • 1220 Chester Pike

    Sharon Hill, PA 190791902

    Phone: (610) 586-2122

    Type: Location

  • 154 EXTON SQUARE MALL STE 154

    EXTON, PA 193412440

    Phone: (484) 565-1293

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-09-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170922001813INurse PractitionerPATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19086)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951215201View full group profile

Reviews

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Frequently asked questions

What NPI should I save for MS. NICOLE DEMATTO (CRNP)?
Save NPI 1497103790 if you need a stable reference for MS. NICOLE DEMATTO (CRNP).
Is MS. NICOLE DEMATTO (CRNP) currently active in the NPI registry?
CMS-published data lists MS. NICOLE DEMATTO (CRNP) as an active registrant.
What field does MS. NICOLE DEMATTO (CRNP) work in?
You can think of MS. NICOLE DEMATTO (CRNP) as practicing within Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for MS. NICOLE DEMATTO (CRNP)?
The page summarizes Wallingford, Pennsylvania for MS. NICOLE DEMATTO (CRNP); expand the address list for detail.
Is MS. NICOLE DEMATTO (CRNP) a real provider?
This page reflects official NPPES data for NPI 1497103790. Always confirm identity and privileges with the practice and licensing boards.

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