Wyncote Physical Medicine & Diagnostic PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD039601L Issued in PA

Legal business name

WYNCOTE PHYSICAL MEDICINE & DIAGNOSTIC PC

Practice address

25 Washington LN
Ste 13C
Wyncote, PA 19095-1400

Phone

(215) 887-5030

Fax

(215) 887-5525

NPI assigned

Sep 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Amelia L Tabuena, MDNPI 1245225473

Title

Attending Physician

Phone

(215) 887-5030

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

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

• Amelia L a Tabuena, MD

  • Physical Medicine & Rehabilitation Physician
  • Willow Grove, PA
  • NPI 1245225473
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043311764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WASHINGTON LN",
            "address_2": "STE 13C",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190951400",
            "telephone_number": "215-887-5030",
            "fax_number": "215-887-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WASHINGTON LN",
            "address_2": "STE 13C",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190951400",
            "telephone_number": "215-887-5030",
            "fax_number": "215-887-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNCOTE PHYSICAL MEDICINE & DIAGNOSTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TABUENA",
        "authorized_official_first_name": "AMELIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ATTENDING PHYSICIAN",
        "authorized_official_telephone_number": "215-887-5030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD039601L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Hampton Woods, RNPMHCNS-BC
• Wyncote Care LLC
• Wyncote Church Home
• Wyncote Healthcare Corp
• Wyncote Healthcare LLC
• Yana Medical LLC
• Wai Shing Yee, DPT

• Physical Medicine & Rehabilitation Physician in Wyncote, PA
• Providers in Wyncote, PA by specialty
• Physical Medicine & Rehabilitation Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.