NPIMap

Organization Active NPI

Einstein Practice Plan,Inc

  • Urology Physician
  • Philadelphia, PA
National Provider Identifier
1154760809
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
EINSTEIN PRACTICE PLAN,INC
Practice address
5401 Old York Rd
Klein BLDG, Suite 101
Philadelphia, PA 19141-3030
Phone
(215) 663-6067
NPI assigned
Jun 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Authorized official

Name
Mary Jackson
Title
Director
Phone
(215) 456-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

5401 Old York Rd
Klein BLDG, Suite 101
Philadelphia, PA 19141-3030

Mailing address

PO Box 788735
Philadelphia, PA 19178-8735
Phone (215) 456-7000

Other names 1

  • Einstein Urology Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000728 PA Part B Supplier - Clinic/Group Practice 2769395896 Receives reassigned benefits from 1,396 practitioners
42 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 42

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 42

National Provider Directory

National Provider Directory

Locations

50 Township Line Rd
Fl 2
Elkins Park, PA 19027
Phone (215) 663-6067

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1154760809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788735",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191788735",
            "telephone_number": "215-456-7000",
            "fax_number": "215-456-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD YORK RD",
            "address_2": "KLEIN BLDG, SUITE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413030",
            "telephone_number": "215-663-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EINSTEIN PRACTICE PLAN,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-17",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "215-456-7000"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Einstein Urology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.