Active NPI
Vital Primary Care Clinic LLC
- General Practice Physician
- Philadelphia, PA
National Provider Identifier
1174413124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Arlenia Paulino
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D2335916 | Vital Primary Care Clinic LLC | Certificate of waiver | Dec 18, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Emergency Medicine Physician
- Tampa, FL
- NPI 1669428371
General Practice, PA
-
- Adult Companion
- Tampa, FL
- NPI 1992470983
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.