Individual provider Active NPI

Daniel Henry Conway, MD

  • Pediatric Allergy/Immunology Physician
  • Philadelphia, PA
National Provider Identifier
1043274376
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
MD063466L Issued in PA
Practice address
160 E. Erie Ave
Philadelphia, PA 19134-1011
Phone
(215) 427-8363
Fax
(215) 427-4385
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD063466L PA
Pediatrics Physician 208000000X MD063466L PA
Neonatal-Perinatal Medicine Physician 2080N0001X MD063466L PA
Pediatric Allergy/Immunology Physician 2080P0201X MD063466L PA Primary

Addresses

Primary practice location

160 E. Erie Ave
Philadelphia, PA 19134-1011

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-1324

Other identifiers 3

IdentifierTypeStateIssuer
061676-LOtherPASTATE MEDICAL LICENSE
0018142830003MedicaidPA
043969OtherPWHCFA PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110303000415 PA Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 7315129954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Temple University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
STC Pediatrics LLCGroup PAC ID 7315372323, 73 clinicians

Practice addresses (Care Compare)

160 E Erie Ave
Philadelphia, PA 19134-1011
Phone (215) 427-8363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD063466LPAMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
STC Pediatrics LLC Pediatrics Current Accepting new patients
STC Pediatrics LLC Allergy & Immunology CurrentSince Feb 24, 2022 Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Feb 24, 2022 Accepting new patients

Locations

500 York Rd
Ste 250
Jenkintown, PA 19046
Phone (215) 572-5300

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1043274376",
    "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",
            "telephone_number": "484-628-1324",
            "fax_number": "215-427-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E. ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-8363",
            "fax_number": "215-427-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "DANIEL",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2023-03-07",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "PA",
            "license": "MD063466L",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD063466L",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "PA",
            "license": "MD063466L",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "PA",
            "license": "MD063466L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "061676-L",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018142830003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCFA PIN",
            "identifier": "043969",
            "state": "PW"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.