NPIMap

Organization Active NPI

Academic Urology of PA,LLC

  • Urology Physician
  • Norristown, PA
National Provider Identifier
1003148966
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD031222E Issued in PA
Legal business name
ACADEMIC UROLOGY OF PA,LLC
Practice address
1313 Dekalb St
Norristown, PA 19401-3403
Phone
(610) 272-1881
Fax
(610) 275-8819
NPI assigned
Feb 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David J Ellis, M.D.
Title
President
Phone
(610) 525-6580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X MD031222E PA Primary

Addresses

Primary practice location

1313 Dekalb St
Norristown, PA 19401-3403

Mailing address

919 Conestoga Rd
Building One, Suite 300
Bryn Mawr, PA 19010-1352
Phone (610) 525-6580

National Provider Directory

National Provider Directory
Tax ID family
Academic Urology of PA LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1003148966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 CONESTOGA RD",
            "address_2": "BUILDING ONE, SUITE 300",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101352",
            "telephone_number": "610-525-6580",
            "fax_number": "610-525-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 DEKALB ST",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194013403",
            "telephone_number": "610-272-1881",
            "fax_number": "610-275-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMIC UROLOGY OF PA,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-525-6580",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "PA",
            "license": "MD031222E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norristown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.