Pediatric Care Group, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PEDIATRIC CARE GROUP, P.C.

Practice address

261 Old York Road
Suite 620
Jenkintown, PA 19046

Phone

(215) 885-8700

Fax

(215) 885-8795

NPI assigned

Jun 17, 2014

Organization subpart

Yes

Parent organization

PEDIATRIC CARE GROUP, P.C.As reported in NPPES

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

Authorized official

Name

Marylee Mundell, D.O.

Title

Managing Physician

Phone

(215) 885-8700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PCG Internal Medicine Doing business as

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.

• Pediatric Care Group, P.C.

  • Pediatrics Physician
  • Richboro, PA
  • NPI 1023652708
  NPD tax ID
• Pediatric Care Group, P.C.

  • Pediatrics Physician
  • Jenkintown, PA
  • NPI 1760451421
  NPD tax ID

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013372830001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1497162",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCG Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul-Durocher Certified Registered Nurse Practitioner Consultants
• Katherine Lorraine Paz
• PCG Internal Medicine PC
• Pearle Vision Inc
• Trisha Monique Pearson, LPC
• Pediatric Care Group, P.C.
• Peds 360 Plus Corp
• Kelly McGrath Pellathy, NP
• Penn Asian Serior Services, Inc.
• Pennsylvania Care Associates

• All providers in Jenkintown, PA
• Internal Medicine Physician in Pennsylvania

• 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.