NPIMap

Organization Active NPI

Chestnut Hill Clinic Company, LLC

Doing business as Telemedicine Chestnut Hill Tower Health Medical Group

  • Neurology Physician
  • Philadelphia, PA
National Provider Identifier
1285274969
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
CHESTNUT HILL CLINIC COMPANY, LLC
Doing business as
Telemedicine Chestnut Hill Tower Health Medical Group
Practice address
8835 Germantown Ave
Philadelphia, PA 19118-2718
Phone
(215) 248-8400
NPI assigned
Jan 10, 2020
Last updated
Jan 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Authorized official

Name
Gary Conner
Title
VP & Cfo
Phone
(484) 628-8181

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X
Neurology Physician 2084N0400X Primary
Psychiatry Physician 2084P0800X

Addresses

Primary practice location

8835 Germantown Ave
Philadelphia, PA 19118-2718

Mailing address

PO Box 13579
Reading, PA 19612-3579

Other names 1

  • Telemedicine Chestnut Hill Tower Health Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070109000509 PA Part B Supplier - Clinic/Group Practice 2860492279 Receives reassigned benefits from 197 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA; Plymouth Meeting, PA; Roxborough, PA; Wayne, PA; Blue Bell, PA; Wyncote, PA; Wyndmoor, PA; Lafayette Hill, PA…

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Chestnut Hill Clinic Company2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Locations

8815 Germantown Ave
Ste 22
Philadelphia, PA 19118
Phone (215) 248-4340

8815 Germantown Ave
Ste 34
Philadelphia, PA 19118
Phone (215) 247-3082

1000 Easton Rd
Ste 260
Wyncote, PA 19095
Phone (215) 884-8815

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1267/brand/2/csg/121/fhir/r4

Practitioners & affiliated clinicians

Practitioners 41

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 41

NPI Registry JSON

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578960000000",
    "number": "1285274969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8835 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191182718",
            "telephone_number": "215-248-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTNUT HILL CLINIC COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "VP & CFO",
        "authorized_official_telephone_number": "484-628-8181"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Telemedicine Chestnut Hill Tower Health Medical Group",
            "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 Jan 14, 2020; 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.