Individual provider Active NPI

Christine A. Laine, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1124049812
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD047292L Issued in PA
Practice address
833 Chestnut St
Suite 220
Philadelphia, PA 19107-4414
Phone
(215) 955-8465
Fax
(215) 955-2516
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD047292L PA Primary

Addresses

Primary practice location

833 Chestnut St
Suite 220
Philadelphia, PA 19107-4414

Mailing address

833 Chestnut St
Suite 220
Philadelphia, PA 19107-4414

Other identifiers 2

IdentifierTypeStateIssuer
7710607MedicaidNJ
001285291MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050126000869 PA Practitioner - Internal Medicine 8022068121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Stony Brook, School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

833 Chestnut St
East 2ND FLR Suite 220
Philadelphia, PA 19107-5102
Phone (215) 955-8465

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Internal Medicine CurrentSince Jul 8, 1992 Accepting new patients
Jefferson University Physicians Past Accepting new patients
Thomas Jefferson University Hospitals Inc PastSince Jul 8, 1992 Accepting new patients

Locations

833 Chestnut St
Frnt 2
Philadelphia, PA 19107
Phone (215) 955-2542

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

833 Chestnut St
Ste 220
Philadelphia, PA 19107
Phone (215) 955-2363

833 Chestnut St
Ste 701
Philadelphia, PA 19107
Phone (215) 955-0735

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1124049812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "SUITE 220",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "SUITE 220",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414",
            "telephone_number": "215-955-8465",
            "fax_number": "215-955-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAINE",
        "first_name": "CHRISTINE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD047292L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7710607",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001285291",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.