Active NPI
Internal Medicine Associates, P C
- Adolescent Medicine (Internal Medicine) Physician
- West Grove, PA
National Provider Identifier
1104989078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent Medicine (Internal Medicine) Physician
- License
- OS004477L
- Legal business name
- INTERNAL MEDICINE ASSOCIATES, P C
- Practice address
- 1011 W Baltimore Pike
Suite 301
West Grove, PA 19390-9446 - Phone
- (610) 869-3620
- Fax
- (610) 869-0358
- NPI assigned
- Dec 19, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Donna Ciletti
- Title
- Practice Manager
- Phone
- (610) 869-3620
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent Medicine (Internal Medicine) Physician | 207RA0000X | OS004477L | PA | Primary |
Addresses
Primary practice location
1011 W Baltimore Pike
Suite 301
West Grove, PA 19390-9446
Mailing address
1011 W Baltimore Pike
Suite 301
West Grove, PA 19390-9446
Phone (610) 869-3620
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00128877600001 | Medicaid | PA |
National Provider Directory
National Provider DirectoryLocations
1011 W Baltimore Pike
Ste 301
West Grove, PA 19390
Phone (610) 869-3620
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- West Grove, PA
- NPI 1336102961
-
- Pulmonary Disease Physician
- Irvine, CA
- NPI 1598055709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1203033600000",
"number": "1104989078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 W BALTIMORE PIKE",
"address_2": "SUITE 301",
"city": "WEST GROVE",
"state": "PA",
"postal_code": "193909446",
"telephone_number": "610-869-3620",
"fax_number": "610-869-0358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 W BALTIMORE PIKE",
"address_2": "SUITE 301",
"city": "WEST GROVE",
"state": "PA",
"postal_code": "193909446",
"telephone_number": "610-869-3620",
"fax_number": "610-869-0358"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTERNAL MEDICINE ASSOCIATES, P C",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-19",
"last_updated": "2008-02-15",
"status": "A",
"authorized_official_last_name": "CILETTI",
"authorized_official_first_name": "DONNA",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "610-869-3620",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207RA0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Adolescent Medicine",
"state": "PA",
"license": "OS004477L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00128877600001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Grove, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.