NPIMap

Organization Active NPI

The Milton S Hershey Medical Center Physicians Group

  • Pediatric Adolescent Medicine Physician
  • Hershey, PA
National Provider Identifier
1093780322
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
135101 Issued in PA
Legal business name
THE MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP
Practice address
905 Governor Rd
Hershey, PA 17033
Phone
(800) 243-1455
NPI assigned
Feb 21, 2006
Last updated
Jan 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Donald McKenna
Title
Predient
Phone
(717) 531-3979

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X 135101 PA
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X 135101 PA Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X 135101 PA

Addresses

Primary practice location

905 Governor Rd
Hershey, PA 17033

Mailing address

PO Box 858
McA410
Hershey, PA 17033-0858
Phone (717) 531-1159

Other identifiers 1

IdentifierTypeStateIssuer
1007452910089MedicaidPA

Other names 1

  • UPG Adolescent Medicine Other name

National Provider Directory

National Provider Directory
Tax ID family
Milton S Hershey Medica74 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1093780322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MCA410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "717-531-1159",
            "fax_number": "717-531-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 GOVERNOR RD",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "17033",
            "telephone_number": "800-243-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "MCKENNA",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PREDIENT",
        "authorized_official_telephone_number": "717-531-3979"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "135101",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "PA",
            "license": "135101",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "135101",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007452910089",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UPG Adolescent Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hershey, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.