NPIMap

Organization Active NPI

Everest Medical Care LLC

  • Clinic/Center
  • Havertown, PA
National Provider Identifier
1104878339
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MD058825L Issued in PA
Legal business name
EVEREST MEDICAL CARE LLC
Practice address
2010 W Chester Pike
Suite 118
Havertown, PA 19083-2700
Phone
(215) 200-5891
Fax
(610) 649-3658
NPI assigned
May 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Xiaobin Li, M.D.NPI 1346225034
Title
Medical Director
Phone
(215) 200-5891

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MD058825L PA Primary

Addresses

Primary practice location

2010 W Chester Pike
Suite 118
Havertown, PA 19083-2700

Mailing address

2010 W Chester Pike
Suite 118
Havertown, PA 19083-2700
Phone (215) 200-5891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060526000013 PA Part B Supplier - Clinic/Group Practice 1658382908 Receives reassigned benefits from 12 practitioners
Practice locations: Philadelphia, PA; Wayne, PA; Upper Darby, PA; Havertown, PA; Chester, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2120622Everest Medical Care LLC2010 West Chester PK #448, Havertown, PA 19083Certificate of waiverOct 19, 2026

National Provider Directory

National Provider Directory

Locations

2600 W 9th St
Unit E2
Chester, PA 19013
Phone (484) 480-4700

2010 W Chester Pike
Ste 118
Havertown, PA 19083
Phone (215) 200-5891

649 Foulkrod St
Unit 302
Philadelphia, PA 19120
Phone (267) 682-5600

6787 Market St
Ste 107
Upper Darby, PA 19082
Phone (610) 352-8000

480 E Swedesford Rd
Ste 120
Wayne, PA 19087
Phone (610) 673-0070

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104878339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 W CHESTER PIKE",
            "address_2": "SUITE 118",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832700",
            "telephone_number": "215-200-5891",
            "fax_number": "610-649-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 W CHESTER PIKE",
            "address_2": "SUITE 118",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832700",
            "telephone_number": "215-200-5891",
            "fax_number": "610-649-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVEREST MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "XIAOBIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "215-200-5891",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "MD058825L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.