Covenant House Inc
A Medicare group practice based in Philadelphia, PA: 4 NPIs enrolled under one PECOS associate control ID (PAC ID 3476591686), with 16 clinicians.
Medicare enrollment
Medicare enrollment files- PAC ID
- 3476591686
- Provider type
- Part A Provider - Federally Qualified Health Center (FQHC), Part B Supplier - Clinic/Group Practice
- Enrolled in
- PA
- Enrollments
- 5
- Group size
- 4 clinicians
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Practice locations
- 5
Enrollment records 5
| Enrollment ID | State | Provider type | NPI |
|---|---|---|---|
| O20111107000566 | PA | Part A Provider - Federally Qualified Health Center (FQHC) | 1528392008 |
| O20050419000796 | PA | Part B Supplier - Clinic/Group Practice | 1659462679 |
| O20200127000062 | PA | Part A Provider - Federally Qualified Health Center (FQHC) | 1699190561 |
| O20161130000041 | PA | Part A Provider - Federally Qualified Health Center (FQHC) | 1659462679 |
| O20231122001525 | PA | Part A Provider - Federally Qualified Health Center (FQHC) | 1669177911 |
NPIs in this group 4
NPPES NPI RegistryThese NPI records belong to the same enrolled organization. Each has its own page.
-
Covenant House Inc
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1659462679
-
Covenant House Inc
- Pediatrics Physician
- Philadelphia, PA
- NPI 1669177911
-
Covenant House Inc
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1699190561
-
Covenant House, Inc
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1528392008
Practice locations
- Philadelphia, PA5
Clinicians 16
Clinicians who reassign their Medicare benefits to this group (16) or whom Care Compare lists as members (4).
-
Juanita Burton, MD
- Obstetrics & Gynecology Physician
- Philadelphia, PA
- NPI 1124067699
-
Tryphena Shen Hsi, CRNP
- Nurse Practitioner
- Philadelphia, PA
- NPI 1942784731
-
Nyeemah Kennedy, MD
- Family Medicine Physician
- Pottstown, PA
- NPI 1831710185
-
Alvin Kingcade, PA-C
- Physician Assistant
- Marlton, NJ
- NPI 1881711125
-
Mark Everett Kobb, M.D.
- Pediatrics Physician
- Philadelphia, PA
- NPI 1609817923
-
Lily Grace Leymeister, PA-C
- Medical Physician Assistant
- Philadelphia, PA
- NPI 1952027567
-
Karema Lucas, NP
- Family Nurse Practitioner
- Philadelphia, PA
- NPI 1568299337
-
Jeannie M Peake, BSN, MSN, CRNP
- Adult Health Nurse Practitioner
- Philadelphia, PA
- NPI 1801065842
-
Maasi Jacob Smith, DPM
- Foot & Ankle Surgery Podiatrist
- Bala Cynwyd, PA
- NPI 1427094259
-
Regina E Stanton, CRNP
- Family Nurse Practitioner
- Wyncote, PA
- NPI 1548337819
-
Susan Denise Stukes, DDS
- Dentist
- Philadelphia, PA
- NPI 1306146923
-
Shannon Voelker, CRNP
- Pediatric Nurse Practitioner
- Philadelphia, PA
- NPI 1033864657
-
Joel I Wagman, MD
- Family Medicine Physician
- Philadelphia, PA
- NPI 1609860519
-
Patrick Timothy Waters, D.O., F.A.A.F.P
- Geriatric Medicine (Family Medicine) Physician
- Philadelphia, PA
- NPI 1356302715
-
Kelley J White, MD
- Pediatrics Physician
- Plymouth, NH
- NPI 1902952906
-
Stacey Woodson, MS, RD, LDN
- Registered Dietitian
- Newtown Square, PA
- NPI 1558685065
Sources for this page
- Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
- Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
- NPPES NPI Registry: the names and addresses of the NPIs above.