LUCIANNE KOROMA MSN, AGACNP
NPI 1356120984
Nurse Practitioner - Critical Care Medicine in Philadelphia, PA

Active since September 25, 2023PECOS EnrolledAccepts Medicare Assignment
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104(215) 964-7419 Get Directions Write a Review

NPPES record last updated: September 25, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Lucianne Koroma Msn, Agacnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LUCIANNE KOROMA MSN, AGACNP (NPI 1356120984) is an individual critical care medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP028203) and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS, is affiliated with Temple University Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1356120984
Entity TypeIndividualFemale
Primary Taxonomy363LC0200X
Provider Legal NameLUCIANNE KOROMACredential: MSN, AGACNP
Location Address3400 CIVIC CENTER BLVDPhiladelphia, PA 19104-5127
Mailing Address17520 Mina LnDumfries, VA 22025-3642 · (703) 851-5894
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateSeptember 25, 2023
NPPES CertifiedSeptember 23, 2023
NPI 1356120984 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Critical Care MedicinePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LC0200X
License Licensed in PA · SP028203
3400 CIVIC CENTER BLVD, Philadelphia, PA 19104

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Lucianne Koroma Msn, Agacnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062932114
PECOS Enrollment IDI20250220000592
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Temple University Hospital

Acute Care Hospitals · Philadelphia, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390027
Location3401 North Broad StreetPhiladelphia, PA 19140 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Pediatrics)
3400 CIVIC CENTER BLVD, ENT DEPT FIRST FLOOR WOOD BLDG
PHILADELPHIA, PA 19104
Internal Medicine (Rheumatology)
3400 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Nurse Practitioner (Pediatrics)
3400 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA, DIVISION OF CARDIO
PHILADELPHIA, PA 19104
Nurse Practitioner (Pediatrics)
3400 CIVIC CENTER BLVD, 5TH FLOOR WOOD BUILDING
PHILADELPHIA, PA 19104
Nurse Practitioner (Pediatrics)
3400 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Nurse Practitioner
3400 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Nurse Practitioner (Family)
3400 CIVIC CENTER BLVD, 5 WOOD
PHILADELPHIA, PA 19104
Nurse Practitioner (Pediatrics)
3400 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA MAIN BUILDING
PHILADELPHIA, PA 19104

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1356120984, enumerated as an "individual" on September 25, 2023.

The provider is located at 3400 CIVIC CENTER BLVD PHILADELPHIA, PA 19104 and the phone number is (215) 964-7419.

Nurse Practitioner with taxonomy code 363LC0200X and a focus in Critical Care Medicine.

Lucianne Koroma is affiliated with: TEMPLE UNIVERSITY HOSPITAL.