NPIMap

Organization Active NPI

Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Phila, PA
National Provider Identifier
1306285176
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PUBLIC HEALTH MANAGEMENT CORPORATION
Practice address
5675 N Front St
Phila, PA 19120-2719
Phone
(215) 279-9666
Fax
(215) 279-9674
NPI assigned
Jun 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Authorized official

Name
Mr. Frank Killian
Title
Director-Operations
Phone
(215) 985-2514

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X PA Primary

Addresses

Primary practice location

5675 N Front St
Phila, PA 19120-2719

Mailing address

1500 Market St
LM 500 West Tower
Phila, PA 19102-2100
Phone (215) 985-2500

Other identifiers 1

IdentifierTypeStateIssuer
1000016640061MedicaidPA

Other names 1

  • Rising Sun Health Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060504000213 PA Part B Supplier - Clinic/Group Practice 1850307406 Receives reassigned benefits from 109 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA; Flourtown, PA

Other NPIs on the same Medicare enrollment 17

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

View all 17

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0875599PHMC Rising Sun Health Center5675 N Front Street, Philadelphia, PA 19120Provider-performed microscopyFeb 23, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1371168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1306285176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MARKET ST",
            "address_2": "LM 500 WEST TOWER",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191022100",
            "telephone_number": "215-985-2500",
            "fax_number": "267-765-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 N FRONT ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191202719",
            "telephone_number": "215-279-9666",
            "fax_number": "215-279-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HEALTH MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-14",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "KILLIAN",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "DIRECTOR-OPERATIONS",
        "authorized_official_telephone_number": "215-985-2514",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000016640061",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rising Sun Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.