NPIMap

Individual provider Active NPI

Terri A McFillin Petrongolo, DO

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1144258260
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS010339L Issued in PA
Practice address
3819 Chestnut Street
Suite 205
Philadelphia, PA 19104-3237
Phone
(215) 662-8777
NPI assigned
Jun 29, 2006
Last updated
May 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS010339L PA Primary

Addresses

Primary practice location

3819 Chestnut Street
Suite 205
Philadelphia, PA 19104-3237

Mailing address

3819 Chestnut Street
Suite 205
Philadelphia, PA 19104-3237
Phone (215) 662-8777

Other identifiers 1

IdentifierTypeStateIssuer
0019243100002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120227000449 PA Practitioner - Family Practice 0941468607 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3801 Filbert St
Penn Center for Primary Care
Philadelphia, PA 19104-2640
Phone (215) 662-9990

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS010339LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Current Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients

Locations

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3701 Market St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-2250

3737 Market St
#9
Philadelphia, PA 19104
Phone (215) 294-9525

3819 Chestnut St
Ste 205
Philadelphia, PA 19104
Phone (215) 662-2354

Organizations & group practices 6

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

Hospital & facility affiliations 4

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1144258260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3819 CHESTNUT STREET",
            "address_2": "SUITE 205",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043237",
            "telephone_number": "215-662-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3819 CHESTNUT STREET",
            "address_2": "SUITE 205",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043237",
            "telephone_number": "215-662-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFILLIN PETRONGOLO",
        "first_name": "TERRI",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS010339L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019243100002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.