NPIMap

Organization Active NPI

Prospect Health Access Network, Inc.

  • Diagnostic Radiology Physician
  • Chester, PA
National Provider Identifier
1154776797
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PROSPECT HEALTH ACCESS NETWORK, INC.
Practice address
1 Medical Center Blvd
Chester, PA 19013-3902
Phone
(302) 477-9660
Fax
(302) 477-9495
NPI assigned
May 2, 2016
Last updated
Jul 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Robert Jon Elders
Title
Secretary
Phone
(714) 788-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1 Medical Center Blvd
Chester, PA 19013-3902

Mailing address

1 Medical Center Blvd
Chester, PA 19013-3902
Phone (302) 477-9660

Other names 1

  • Crozer Health Medical Group Radiology Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY, NV, CA, FL5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20160613000737 PA Part B Supplier - Clinic/Group Practice 5698065142 Receives reassigned benefits from 730 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20240912002840 NY Part B Supplier - Clinic/Group Practice 5698065142 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Vernon, NY
O20240926001234 NV Part B Supplier - Clinic/Group Practice 5698065142 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV
O20241003000440 CA Part B Supplier - Clinic/Group Practice 5698065142 Receives reassigned benefits from 2 practitioners
Practice locations: Huntington Beach, CA; Monterey Park, CA; Santa Monica, CA
O20241010000535 FL Part B Supplier - Clinic/Group Practice 5698065142 Receives reassigned benefits from 2 practitioners
Practice locations: Orlando, FL; Tampa, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 25

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

View all 25

National Provider Directory

National Provider Directory

Locations

2106 Silverside Rd
Ste 2
Wilmington, DE 19810
Phone (302) 477-9660

1 Medical Center Blvd
#3
Chester, PA 19013
Phone (610) 619-7410

1 Medical Center Blvd
#428
Chester, PA 19013
Phone (610) 874-4044

1 Medical Center Blvd
Spc Care
Chester, PA 19013
Phone (610) 447-6328

1 Medical Center Blvd
Ste 220
Chester, PA 19013
Phone (610) 394-1889

1 Medical Center Blvd
Ste 233
Chester, PA 19013
Phone (610) 499-0400

1 Medical Center Blvd
Ste 300
Chester, PA 19013
Phone (610) 619-8500

1 Medical Center Blvd
Ste 306
Chester, PA 19013
Phone (484) 816-2754

1 Medical Center Blvd
Ste 404
Chester, PA 19013
Phone (610) 619-8590

2100 Keystone Ave
Ste 407
Drexel Hill, PA 19026
Phone (610) 259-5007

2100 Keystone Ave
Ste 705
Drexel Hill, PA 19026
Phone (610) 259-7777

458 Baltimore Pike
Ste 202
Glen Mills, PA 19342
Phone (610) 558-9222

500 Evergreen Dr
Ste 330
Glen Mills, PA 19342
Phone (610) 338-1820

2010 W Chester Pike
Ste 350
Havertown, PA 19083
Phone (610) 853-1112

1088 W Baltimore Pike
Ste 2405
Media, PA 19063
Phone (610) 566-6744

4651 West Chester Pike
Newtown Square, PA 19073
Phone (610) 356-0300

1 Bartol Ave
Ste 101
Ridley Park, PA 19078
Phone (610) 362-7495

196 W Sproul Rd
Ste 205
Springfield, PA 19064
Phone (610) 338-1820

1324 Macdade Blvd
Woodlyn, PA 19094
Phone (610) 872-2200

Practitioners & affiliated clinicians

Practitioners 741

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 741

NPI Registry JSON

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1154776797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "302-477-9660",
            "fax_number": "302-477-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "302-477-9660",
            "fax_number": "302-477-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT HEALTH ACCESS NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-02",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "ELDERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "714-788-1249"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crozer Health Medical Group Radiology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.