Individual provider Active NPI

Pek U Ieong

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1053025809
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP026722 Issued in PA
Practice address
1104 Welsh Rd
Philadelphia, PA 19115-3730
Phone
(215) 676-9191
NPI assigned
Jan 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP026722 PA Primary

Addresses

Primary practice location

1104 Welsh Rd
Philadelphia, PA 19115-3730

Mailing address

313 W Wildey St
Philadelphia, PA 19123-2224

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230119002076 PA Practitioner - Nurse Practitioner 0648641126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Penn Medicine-PmaGroup PAC ID 6507269370, 55 clinicians
Ninth Street Internal Medicine Associates LTDGroup PAC ID 5799763702, 14 clinicians

Practice addresses (Care Compare)

700 Walnut Street 1St Floor
R1 Penn Primary Care Walnut Street
Philadelphia, PA 19106-3505
Phone (215) 440-8681

805 Locust St
Philadelphia, PA 19107-5507
Phone (215) 440-8681

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Penn Medicine-Pma CurrentSince Mar 1, 2026 Accepting new patients
Ninth Street Internal Medicine Associates LTD CurrentSince Oct 29, 2023 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health PastSince Mar 1, 2026 Accepting new patients

Locations

150 Monument Rd
Ste 400
Bala Cynwyd, PA 19004
Phone (610) 747-3470

805 Locust St
Philadelphia, PA 19107
Phone (215) 440-8681

805 Locust St
#Ninth
Philadelphia, PA 19107

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACJBAA
  • FHIR API: https://ssproxy.pennhealth.com/PRD-FHIR/api/FHIR/R4/

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1053025809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 W WILDEY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191232224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 WELSH RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191153730",
            "telephone_number": "215-676-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IEONG",
        "first_name": "PEK",
        "middle_name": "U",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP026722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.