NPIMap

Organization Active NPI

Methodist Hospital

  • Ambulatory Surgical Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1174667232
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
200801 Issued in PA
Legal business name
METHODIST HOSPITAL
Practice address
2301 S Broad St
Philadelphia, PA 19148-3542
Phone
(215) 955-7106
Fax
(215) 955-8732
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Neil Lubarsky
Title
Senior Vice President for Finance
Phone
(215) 955-9895

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 200801 PA Primary

Addresses

Primary practice location

2301 S Broad St
Philadelphia, PA 19148-3542

Mailing address

2301 S Broad St
Philadelphia, PA 19148-3542
Phone (215) 955-7106

Other identifiers 1

IdentifierTypeStateIssuer
1007571300055MedicaidPA

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
39D1039462Methodist Hospital Division Tjuh Inc2301 S Broad St, Philadelphia, PA 19148Certificate of waiverMay 31, 2028

National Provider Directory

National Provider Directory
Tax ID family
Thomas Jefferson Univ H13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174667232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191483542",
            "telephone_number": "215-955-7106",
            "fax_number": "215-955-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191483542",
            "telephone_number": "215-955-7106",
            "fax_number": "215-955-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUBARSKY",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT FOR FINANCE",
        "authorized_official_telephone_number": "215-955-9895",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "200801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007571300055",
            "state": "PA"
        }
    ],
    "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.