Individual provider Active NPI

Alexis Victoria Drennen, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1053694190
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA055143 Issued in PA
Practice address
925 Chestnut St
5TH Floor
Philadelphia, PA 19107-4216
Phone
(269) 339-3500
NPI assigned
Sep 26, 2011
Last updated
Feb 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA055143 PA Primary

Addresses

Primary practice location

925 Chestnut St
5TH Floor
Philadelphia, PA 19107-4216

Mailing address

833 Chestnut St
Suite1402
Philadelphia, PA 19107-4414
Phone (267) 339-3500

Other names 1

  • Alexis Victoria Pino Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111118000066 PA Practitioner - Physician Assistant 1951575422 Reassigns benefits to 1 organization
I20120119000327 NJ Practitioner - Physician Assistant 1951575422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

925 Chestnut St
FL 5
Philadelphia, PA 19107-4206
Phone (267) 339-3500

999 Route 73 N
Suite 401
Marlton, NJ 08053-1227
Phone (800) 321-9999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.57 of 100Reported as group
Quality
86.68
Promoting interoperability
99
Improvement activities
40
Cost
89.37

Merit-based Incentive Payment System (MIPS)

Final score
88.32 of 100Reported as group
Quality
79.04
Promoting interoperability
99
Improvement activities
40
Cost
82.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Oct 3, 2011 Accepting new patients
Rothman Institute of New Jersey, P.a. CurrentSince Jan 1, 2012 Accepting new patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Oct 3, 2011 Accepting new patients

Locations

2500 English Creek Ave
Ste 1300
Egg Hbr Twp, NJ 08234
Phone (609) 677-6060

999 Route 73 N
Ste 401
Marlton, NJ 08053
Phone (609) 617-3546

833 Chestnut St
Ste 1220
Philadelphia, PA 19107
Phone (352) 200-2872

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

Interoperability endpoints

  • Direct secure messaging: adrennen319717@direct.cooperhealth.edu
  • Direct secure messaging: alexis.drennen@rot.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1053694190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "SUITE1402",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414",
            "telephone_number": "267-339-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST",
            "address_2": "5TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "269-339-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRENNEN",
        "first_name": "ALEXIS",
        "middle_name": "VICTORIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "PINO",
            "middle_name": "VICTORIA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.