NPIMap

Organization Active NPI

Clinical Specialty Associates

  • Urology Physician
  • Bala Cynwyd, PA
National Provider Identifier
1104619170
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
CLINICAL SPECIALTY ASSOCIATES
Practice address
150 Monument Rd FL 4
Bala Cynwyd, PA 19004-1702
Phone
(610) 902-1738
NPI assigned
May 23, 2025
Last updated
May 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Authorized official

Name
Stacy Greco
Title
Payer Supervisor
Phone
(223) 341-8516

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

150 Monument Rd FL 4
Bala Cynwyd, PA 19004-1702

Mailing address

150 Monument Rd FL 4
Bala Cynwyd, PA 19004-1702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250608000029 PA Part B Supplier - Clinic/Group Practice 5799295853 Receives reassigned benefits from 191 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Chester, PA; Warrington, PA; Warminster, PA; Springfield, PA; Sellersville, PA; Schwenksville, PA; Phoenixville, PA; Philadelphia, PA…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Clinical Specialty Associates19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 10

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": "1747958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1104619170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD FL 4",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD FL 4",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041702",
            "telephone_number": "610-902-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL SPECIALTY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "GRECO",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "PAYER SUPERVISOR",
        "authorized_official_telephone_number": "223-341-8516"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.