NPIMap

Organization Active NPI

Upenn Life

  • Health Maintenance Organization
  • Philadelphia, PA
National Provider Identifier
1053576835
Registry record updated Jul 22, 2008
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Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
MD421701 Issued in PA
Legal business name
UPENN LIFE
Practice address
4508 Chestnut St
Philadelphia, PA 19139-3608
Phone
(215) 573-7200
NPI assigned
Jul 22, 2008
Organization subpart
Yes
Parent organization
UPENN SCHOOL OF NURSINGAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Authorized official

Name
Dr. Bruce Kinosian, MD
Title
Medical Director
Phone
(215) 573-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X MD421701 PA Primary

Addresses

Primary practice location

4508 Chestnut St
Philadelphia, PA 19139-3608

Mailing address

4508 Chestnut St
Philadelphia, PA 19139-3608
Phone (215) 573-7200

National Provider Directory

National Provider Directory
Tax ID family
Univ of Penn Dept of NE44 organizations share this tax ID, including this one
Part of
Univ of Penn Dept of NE

Other organizations with this tax ID 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1053576835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4508 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393608",
            "telephone_number": "215-573-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4508 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393608",
            "telephone_number": "215-573-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPENN LIFE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UPENN SCHOOL OF NURSING",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "KINOSIAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "215-573-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "PA",
            "license": "MD421701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 22, 2008; 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.