NPIMap

Organization Active NPI

Tower Drexel Academic Medical Group LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Philadelphia, PA
National Provider Identifier
1003459702
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
TOWER DREXEL ACADEMIC MEDICAL GROUP LLC
Practice address
4700 Wissahickon Ave Ste C102
Philadelphia, PA 19144-4248
Phone
(610) 743-6049
NPI assigned
Oct 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Authorized official

Name
Charles Michael Valentino Jr.
Title
VP of Revenue Integrity
Phone
(484) 628-9380

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4700 Wissahickon Ave Ste C102
Philadelphia, PA 19144-4248

Mailing address

PO Box 13579
Reading, PA 19612-3579

Other practice location 1

1427 Vine St Fl 1
Philadelphia, PA 19102-1031
Phone (267) 507-6581

Other practice location 2

1427 Vine St Fl 8
Philadelphia, PA 19102-1040
Phone (267) 507-6581

Other names 1

  • PSYCHIATRY TOWER HEALTH MEDICAL GROUP WISSAHICKON AVENUE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061117000409 PA Part B Supplier - Clinic/Group Practice 9335147784 Receives reassigned benefits from 49 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wyncote, PA; Phildelphia, PA; Philadelphia, PA; Flourtown, PA

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
County Intermediate Unit18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

219 N Broad St
Philadelphia, PA 19107
Phone (215) 762-5037

4700 Wissahickon Ave
Ste C102
Philadelphia, PA 19144
Phone (215) 967-2130

1000 Easton Rd
Ste 260
Wyncote, PA 19095
Phone (215) 884-8815

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1003459702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WISSAHICKON AVE STE C102",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444248",
            "telephone_number": "610-743-6049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1427 Vine St Fl 1",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191021031",
            "country_code": "US",
            "telephone_number": "267-507-6581",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1427 Vine St Fl 8",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191021040",
            "country_code": "US",
            "telephone_number": "267-507-6581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TOWER DREXEL ACADEMIC MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-25",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "VALENTINO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "VP OF REVENUE INTEGRITY",
        "authorized_official_telephone_number": "484-628-9380",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PSYCHIATRY TOWER HEALTH MEDICAL GROUP WISSAHICKON AVENUE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.