Individual provider Active NPI

Starr Patricia Pearson, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1124327101
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-044523E Issued in PA
Practice address
7715 Crittenden St # 115
Philadelphia, PA 19118-4421
Phone
(215) 205-3724
Fax
(215) 205-3723
NPI assigned
Mar 16, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

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 MD-044523E PA Primary

Addresses

Primary practice location

7715 Crittenden St # 115
Philadelphia, PA 19118-4421

Mailing address

7715 Crittenden St # 115
Philadelphia, PA 19118-4421
Phone (215) 205-3724

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
I20140326001252 PA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1951532431

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-044523EPAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1124327101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7715 CRITTENDEN ST # 115",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191184421",
            "telephone_number": "215-205-3724",
            "fax_number": "215-205-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7715 CRITTENDEN ST # 115",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191184421",
            "telephone_number": "215-205-3724",
            "fax_number": "215-205-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "STARR",
        "middle_name": "PATRICIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD-044523E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.