Mercy Management of Southeastern Pennsylvania

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA

Doing business as

Mercy Fitzgerald Surgical Associates

Practice address

1501 Lansdowne Ave
Suite 305
Darby, PA 19023-1333

Phone

(610) 534-6170

Fax

(610) 534-6159

NPI assigned

Nov 15, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Douglas C Smith

Title

Cfo

Phone

(610) 567-6964

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Mercy Fitzgerald Surgical Associates Doing business as

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257379200000",
    "number": "1194707380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "address_2": "2ND FLOOR",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282007",
            "telephone_number": "610-567-6964",
            "fax_number": "610-567-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 LANSDOWNE AVE",
            "address_2": "SUITE 305",
            "city": "DARBY",
            "state": "PA",
            "postal_code": "190231333",
            "telephone_number": "610-534-6170",
            "fax_number": "610-534-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2009-11-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "610-567-6964",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3955657",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHPE",
            "identifier": "2414129000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5746424",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007787930153",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MECY",
            "identifier": "30023892",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1738463",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA5351",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Fitzgerald Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mercy Management of Southeastern Pennsylvani (MMS-Mercy Fitzgerald Hospialist)
• Mercy Management of Southeastern Pennsylvani
• Mercy Management of Southeastern Pennsylvania (Mercy Fitzgearld Cardiology Associates)
• Mercy Management of Southeastern Pennsylvania
• Mercy Management of Southeastern Pennsylvania
• Mercy Management of Southeastern Pennsylvania
• Mercy Management of Southeastern Pennsylvania (Mercy EKG Associates)
• Mercy Management of Southeastern Pennsylvania
• Mercy Management of Southeastern Pennsylvania
• Mercy Management of Southeastern Pennsylvania (MMS-Mercy Pathology Associates)

• Surgery Physician in Darby, PA
• Providers in Darby, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.