Organization Active NPI

Vital Primary Care Clinic LLC

  • General Practice Physician
  • Philadelphia, PA
National Provider Identifier
1174413124
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
VITAL PRIMARY CARE CLINIC LLC
Practice address
3334 N Front St
Philadelphia, PA 19140-5808
Phone
(215) 205-2229
NPI assigned
Jul 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Arlenia PaulinoNPI 1992470983
Title
Member
Phone
(215) 370-4355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

3334 N Front St
Philadelphia, PA 19140-5808

Mailing address

3334 N Front St
Philadelphia, PA 19140-5808
Phone (215) 205-2229

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250916003636 PA Part B Supplier - Clinic/Group Practice 9032613716 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2335916Vital Primary Care Clinic LLC3334 N Front St, Philadelphia, PA 19140Certificate of waiverDec 18, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1174413124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 N FRONT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405808",
            "telephone_number": "215-205-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 N FRONT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405808",
            "telephone_number": "215-205-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL PRIMARY CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-09",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "PAULINO",
        "authorized_official_first_name": "ARLENIA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "215-370-4355"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.