NPIMap

Organization Active NPI

HR Physician Services

Doing business as Redeemer Retirement Community Primary Care

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1174073563
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS005558L Issued in PA
Legal business name
HR PHYSICIAN SERVICES
Doing business as
Redeemer Retirement Community Primary Care
Practice address
8580 Verree Rd
Philadelphia, PA 19111-1370
Phone
(215) 214-3815
Fax
(215) 214-3816
NPI assigned
Oct 10, 2016
Last updated
Oct 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Authorized official

Name
Russell R Wagner
Title
Executive Vice President Finance
Phone
(215) 856-1114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X OS005558L PA Primary

Addresses

Primary practice location

8580 Verree Rd
Philadelphia, PA 19111-1370

Mailing address

12265 Townsend Rd
Philadelphia, PA 19154-1201
Phone (215) 856-1010

Other names 1

  • REDEEMER RETIREMENT COMMUNITY PRIMARY CARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311000028 PA Part B Supplier - Clinic/Group Practice 0042109902 Receives reassigned benefits from 373 practitioners
40 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA; Meadowbrook, PA; Richboro, PA; Rockledge, PA; Southampton, PA; Warminster, PA; Warmister, PA; Willow Grove, PA…

Other NPIs on the same Medicare enrollment 40

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

View all 40

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1174073563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12265 TOWNSEND RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191541201",
            "telephone_number": "215-856-1010",
            "fax_number": "215-698-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8580 VERREE RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191111370",
            "telephone_number": "215-214-3815",
            "fax_number": "215-214-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HR PHYSICIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "215-856-1114"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS005558L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REDEEMER RETIREMENT COMMUNITY PRIMARY CARE",
            "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 Oct 10, 2016; 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.