Active NPI
Courtney Quinlan, D.O.
- Pediatric Pulmonology Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pulmonology Physician
- License
- OT017614
- Practice address
- 3401 Civic Center Blvd
Philadelphia, PA 19104-4319 - Phone
- (215) 590-3363
- NPI assigned
- Apr 1, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Pulmonology Physician | 2080P0214X | OT017614 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Mailing address
3401 Civic Center Blvd
Division of Pediatric Pulmonology
Phialdelphia, PA 19104
Phone (215) 590-3363
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OT017614 | Medicaid | PA |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Touro Un Col of Osteopathic Medicine, New York, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1210 S Cedar Crest Blvd
2700 LVPG Pediatric Pulmonary Medicine
Allentown, PA 18103-6239
Phone (610) 402-3866
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT017614 | PA | MD | Pediatric Pulmonology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lehigh Valley Physician Group | Current | Accepting new patients | |
| Lehigh Valley Physician Group | Current | Accepting new patients | |
| Lehigh Valley Physician Group | Current | Accepting new patients | |
| Pulmonary Associates PC | Past | Accepting new patients |
Locations
2100 Mack Blvd
Fl 4
Allentown, PA 18103
1210 S Cedar Crest Blvd
Ste 2700
Allentown, PA 18103
Phone (610) 402-3866
320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240
Interoperability endpoints
- cquinlan589395@direct2.lvhn.org
Organizations & group practices 5
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.
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-
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1083032601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF PEDIATRIC PULMONOLOGY",
"city": "PHIALDELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "215-590-3363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044319",
"telephone_number": "215-590-3363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINLAN",
"first_name": "COURTNEY",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-01",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "PA",
"license": "OT017614",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OT017614",
"state": "PA"
}
],
"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 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.