NPIMap

Organization Active NPI

Einstein Practice Plan Inc

Doing business as Einstein Nephrology Associates

  • Nephrology Physician
  • Philadelphia, PA
National Provider Identifier
1174580559
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
EINSTEIN PRACTICE PLAN INC
Doing business as
Einstein Nephrology Associates
Practice address
5501 Old York Rd
Levy Ground Floor
Philadelphia, PA 19141-3018
Phone
(215) 456-6970
Fax
(215) 254-2599
NPI assigned
Apr 28, 2006
Last updated
Dec 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Authorized official

Name
Mary Jackson
Title
Director-Einstein Practice Plan Inc
Phone
(215) 456-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

5501 Old York Rd
Levy Ground Floor
Philadelphia, PA 19141-3018

Mailing address

PO Box 8500-8735
Philadelphia, PA 19178-8735
Phone (215) 456-7000

Other identifiers 1

IdentifierTypeStateIssuer
1007706230139MedicaidPA

Other names 1

  • Einstein Nephrology Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000728 PA Part B Supplier - Clinic/Group Practice 2769395896 Receives reassigned benefits from 1,396 practitioners
42 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 42

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

View all 42

National Provider Directory

National Provider Directory
Tax ID family
Einstien Practice Plan32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Locations

235 W Chelten Ave
Philadelphia, PA 19144
Phone (215) 844-0637

5401 Old York Rd
Ste 505
Philadelphia, PA 19141
Phone (215) 456-6933

5501 Old York Rd
#300
Philadelphia, PA 19141

5501 Old York Rd
Fl MOSS4
Philadelphia, PA 19141

5501 Old York Rd
Ste 300
Philadelphia, PA 19141
Phone (215) 456-6950

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356912000000",
    "number": "1174580559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500-8735",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191788735",
            "telephone_number": "215-456-7000",
            "fax_number": "215-254-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "LEVY GROUND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-6970",
            "fax_number": "215-254-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EINSTEIN PRACTICE PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2012-12-31",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR-EINSTEIN PRACTICE PLAN INC",
        "authorized_official_telephone_number": "215-456-7000"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007706230139",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Einstein Nephrology Associates",
            "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 Dec 31, 2012; 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.