Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Egoville, NP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1336410851

Justin Egoville, NP is a Nurse Practitioner in Philadelphia, Pennsylvania. Qualified in 2010, 16 years ago. Practices with Codac Health Recovery and Wellness, a 28-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Pennsylvania.

Years since qualifying
16
Licensed in
PA
In the registry since
2012
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

80001 State Rd Mhm Correctional Services Mod Ii
Philadelphia, PA 19136-0000
Phone: (215) 624-0797
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence SP011762 (PA)

Record details

NPI number1336410851
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedJanuary 13, 2012
Last updated in NPPESJanuary 13, 2012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Codac Health Recovery And Wellness — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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