Organization Active NPI

Ingleside Medical Associates LLC

  • Family Medicine Physician
  • Thorndale, PA
National Provider Identifier
1295790137
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INGLESIDE MEDICAL ASSOCIATES LLC
Practice address
200 Municipal Dr
Thorndale, PA 19372-1016
Phone
(610) 383-6300
Fax
(610) 383-0114
NPI assigned
Apr 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Authorized official

Name
Mrs. Anna Marie Finley
Title
Office Manager
Phone
(610) 383-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X PA Primary

Addresses

Primary practice location

200 Municipal Dr
Thorndale, PA 19372-1016

Mailing address

200 Municipal Dr
Thorndale, PA 19372-1016
Phone (610) 383-6300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040621001305 PA Part B Supplier - Clinic/Group Practice 6507841954 Receives reassigned benefits from 8 practitioners
Practice locations: Parkesburg, PA; Thorndale, PA

National Provider Directory

National Provider Directory

Locations

4223 W Lincoln Hwy
Parkesburg, PA 19365
Phone (215) 383-6300

200 Municipal Dr
Thorndale, PA 19372
Phone (484) 889-2523

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GBFEBA

Practitioners & affiliated clinicians

Practitioners 8

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": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258934400000",
    "number": "1295790137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MUNICIPAL DR",
            "city": "THORNDALE",
            "state": "PA",
            "postal_code": "193721016",
            "telephone_number": "610-383-6300",
            "fax_number": "610-383-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MUNICIPAL DR",
            "city": "THORNDALE",
            "state": "PA",
            "postal_code": "193721016",
            "telephone_number": "610-383-6300",
            "fax_number": "610-383-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGLESIDE MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2009-11-23",
        "status": "A",
        "authorized_official_last_name": "FINLEY",
        "authorized_official_first_name": "ANNA MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "610-383-6300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thorndale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; 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.