Organization Active NPI

Pediatric Care Group, P.C.

Doing business as PCG Internal Medicine

  • Internal Medicine Physician
  • Jenkintown, PA
National Provider Identifier
1093129157
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PEDIATRIC CARE GROUP, P.C.
Doing business as
PCG Internal Medicine
Practice address
261 Old York Road
Suite 620
Jenkintown, PA 19046
Phone
(215) 885-8700
Fax
(215) 885-8795
NPI assigned
Jun 17, 2014
Last updated
Jun 17, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
PEDIATRIC CARE GROUP, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Authorized official

Name
Marylee Mundell, D.O.NPI 1508833609
Title
Managing Physician
Phone
(215) 885-8700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X PA Primary

Addresses

Primary practice location

261 Old York Road
Suite 620
Jenkintown, PA 19046

Mailing address

261 Old York Road
Suite 620
Jenkintown, PA 19046
Phone (215) 885-8700

Other names 1

  • PCG Internal Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Care Group PC3 organizations share this tax ID, including this one
Part of
Pediatric Care Group PC

Other organizations with this tax ID 2

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

Locations

261 Old York Rd
Ste 620
Jenkintown, PA 19046
Phone (215) 579-2616

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1093129157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 OLD YORK ROAD",
            "address_2": "SUITE 620",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "19046",
            "telephone_number": "215-885-8700",
            "fax_number": "215-885-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 OLD YORK ROAD",
            "address_2": "SUITE 620",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "19046",
            "telephone_number": "215-885-8700",
            "fax_number": "215-885-8795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARE GROUP, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRIC CARE GROUP, P.C.",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "MUNDELL",
        "authorized_official_first_name": "MARYLEE",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "215-885-8700",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCG Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jenkintown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.