NPIMap

Organization Active NPI

Elwyn of Pennsylvania and Delaware

  • Community/Behavioral Health Agency
  • Media, PA
National Provider Identifier
1215548615
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ELWYN OF PENNSYLVANIA AND DELAWARE
Practice address
111 Elwyn Rd
Media, PA 19063-4622
Phone
(610) 891-7007
Fax
(610) 891-2666
NPI assigned
Aug 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
Donna K Busch
Title
Payer Contract Specialist
Phone
(445) 206-3028

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

111 Elwyn Rd
Media, PA 19063-4622

Mailing address

111 Elwyn Rd
Media, PA 19063-4622
Phone (610) 891-7007

Other practice location 1

3300 Henry Ave Ste 113
Philadelphia, PA 19129-1146
Phone (215) 254-2046

Other identifiers 1

IdentifierTypeStateIssuer
1000021240700MedicaidPA

Other names 1

  • Evergreen 2 Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@elwyn.org Direct

National Provider Directory

National Provider Directory
Tax ID family
Elwyn Medical Services61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Locations

3300 Henry Ave
Ste 113
Philadelphia, PA 19129
Phone (215) 254-2038

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1215548615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ELWYN RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190634622",
            "telephone_number": "610-891-7007",
            "fax_number": "610-891-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ELWYN RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190634622",
            "telephone_number": "610-891-7007",
            "fax_number": "610-891-2666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Henry Ave Ste 113",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191291146",
            "country_code": "US",
            "telephone_number": "215-254-2046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELWYN OF PENNSYLVANIA AND DELAWARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "BUSCH",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PAYER CONTRACT SPECIALIST",
        "authorized_official_telephone_number": "445-206-3028"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000021240700",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@elwyn.org",
            "affiliation": "N",
            "endpointDescription": "We do not have a method to exchange electronically",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure email",
            "address_1": "111 Elwyn Rd",
            "city": "Media",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190634622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Evergreen 2",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.