NPIMap

Organization Active NPI

Crozer-Chester Medical Center

  • Ambulatory Surgical Clinic/Center
  • Upland, PA
National Provider Identifier
1083776314
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
037201 Issued in PA
Legal business name
CROZER-CHESTER MEDICAL CENTER
Practice address
1 Medical Center Boulevard
Upland, PA 19013-3902
Phone
(610) 447-2000
Fax
(610) 447-6620
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Authorized official

Name
Mr. Patrick Gavin
Title
Coo
Phone
(610) 338-8228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 037201 PA Primary

Addresses

Primary practice location

1 Medical Center Boulevard
Upland, PA 19013-3902

Mailing address

1 Medical Center Boulevard
Upland, PA 19013-3902
Phone (610) 447-2000

Other identifiers 3

IdentifierTypeStateIssuer
1007605830139MedicaidPA
1007605830136MedicaidPA
1007605830073MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Crozer Chester Medical28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1083776314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BOULEVARD",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-447-2000",
            "fax_number": "610-447-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BOULEVARD",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-447-2000",
            "fax_number": "610-447-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROZER-CHESTER MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "610-338-8228",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "037201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007605830139",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007605830136",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007605830073",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.