NPIMap

University of Penn-Medical Group

Organization Active NPI Neurology Physician · Philadelphia, PA

NPI 1164810271 · NPPES record last updated Jul 31, 2025

Key facts

NPI
1164810271
Entity type
Organization (NPI type 2)
Primary specialty
Neurology Physician 2084N0400X
Legal business name
UNIVERSITY OF PENN-MEDICAL GROUP
Practice address
3400 Civic Center Blvd
2ND Floor South Pavillion
Philadelphia, PA 19104-5127
Phone
(215) 662-3606
NPI assigned
Dec 26, 2014
Organization subpart
No

Authorized official

Name
Stacy Greco
Title
Payer Enrollment Manager
Phone
(223) 341-8516

Other NPIs on the same Medicare enrollment 47

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

View all 47

Practitioners 136

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

View all 136

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20141111000091 PA Part B Supplier - Clinic/Group Practice 6204730955 Receives reassigned benefits from 3,792 practitioners
47 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Locations

8815 Germantown Ave
Ste 46
Philadelphia, PA 19118
Phone (215) 242-8260

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084N0400X PA Yes

Addresses

Primary practice location

3400 Civic Center Blvd
2ND Floor South Pavillion
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
2ND Floor South Pavillion
Philadelphia, PA 19104-5127
Phone (215) 662-3606

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Neurology Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.