Kasama Philly

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

KASAMA PHILLY

Practice address

2418 E York St
Philadelphia, PA 19125-3006

Phone

(267) 217-6438

Fax

(806) 454-5682

NPI assigned

Jun 20, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Marissa Tan, DO

Title

Medical Director

Phone

(814) 207-9701

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1205670734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 E YORK ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253006",
            "telephone_number": "267-217-6438",
            "fax_number": "806-454-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 E YORK ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253006",
            "telephone_number": "267-217-6438",
            "fax_number": "806-454-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KASAMA PHILLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "814-207-9701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew James Karsten, DMD
• Gokul Karthikeyan
• Meghan S Karuturi, M.D.
• Dina Karvounides, PSY.D.
• Elena Karzova, MD
• Anoosha Kasanagottu, DO
• Tammaris Rivera Kaschak, FNP-BC, AGACNP-BC
• Adrian Kase, MD
• Medina Kasemi, CRNP
• Mary Jo Kasenchak, D.M.D.

• Health Service Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Health Service Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.