Carissa Susan McIlwain, PA-C

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

OA002318 Issued in PA

Practice address

25 Bala Ave Ste 205
Bala Cynwyd, PA 19004-3215

Phone

(610) 667-6363

NPI assigned

Dec 10, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DBBBCA/Endpoint/DBBBCA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Helene M Koch DO PC

  • Obstetrics & Gynecology Physician
  • Bala Cynwyd, PA
  • NPI 1801854765
  NPD (past)

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1003387572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 OLD OAKS RD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101024",
            "telephone_number": "610-564-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BALA AVE STE 205",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043215",
            "telephone_number": "610-667-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILWAIN",
        "first_name": "CARISSA",
        "middle_name": "SUSAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "OA002318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith L. M. McCoyd, PHD
• Renee L McDonough, MD
• Sarah McGrath
• Amanda Rose McGurk, PA
• Terrence McHugh, PT, DPT, MS, ATC
• Victoria McLeod
• James Patrick McNulty, PT ATC
• McPhillemy, Sachs & Avart PTRS
• McPhillemy, Sachs & Avart PTRS
• Marc David McShane, PT, DPT, CSCS

• Obstetrics & Gynecology Physician in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Obstetrics & Gynecology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.