NPIMap

Organization Active NPI

Trinity Health Mid-Atlantic Medical Group

Doing business as St. Mary Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Langhorne, PA
National Provider Identifier
1053830646
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP
Doing business as
St. Mary Endocrinology
THMA MG Endocrinology Darby
THMA MG Endocrinology Langhorne
Practice address
1205 Langhorne Newtown Rd Ste 302
Langhorne, PA 19047-1222
Phone
(215) 710-5212
Fax
(215) 710-5213
NPI assigned
Sep 14, 2017
Last updated
Dec 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Authorized official

Name
Kimberly Cummings
Title
VP, Finance and Cfo
Phone
(215) 710-2508

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary

Addresses

Primary practice location

1205 Langhorne Newtown Rd Ste 302
Langhorne, PA 19047-1222

Mailing address

41 University Dr Ste 300
Newtown, PA 18940-1873
Phone (734) 343-2654

Other names 3

  • ST. MARY ENDOCRINOLOGY Doing business as
  • THMA MG Endocrinology Darby Doing business as
  • THMA MG Endocrinology Langhorne Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326000613 PA Part B Supplier - Clinic/Group Practice 7416861885 Receives reassigned benefits from 703 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Langhorne Phy Services38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

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

View all 37

Locations

1205 Langhorne Newtown Rd
Ste 302
Langhorne, PA 19047
Phone (215) 710-5212

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1053830646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 UNIVERSITY DR STE 300",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401873",
            "telephone_number": "734-343-2654",
            "fax_number": "215-710-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 LANGHORNE NEWTOWN RD STE 302",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471222",
            "telephone_number": "215-710-5212",
            "fax_number": "215-710-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-14",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "CUMMINGS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "VP, FINANCE AND CFO",
        "authorized_official_telephone_number": "215-710-2508"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. MARY ENDOCRINOLOGY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THMA MG Endocrinology Darby",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THMA MG Endocrinology Langhorne",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Langhorne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.