NPIMap

Organization Active NPI

Tower Drexel Academic Medical Group LLC

Doing business as Sports Medicine Tower Health Medical Group Manayunk

  • Sports Medicine (Family Medicine) Physician
  • Philadelphia, PA
National Provider Identifier
1306479829
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
TOWER DREXEL ACADEMIC MEDICAL GROUP LLC
Doing business as
Sports Medicine Tower Health Medical Group Manayunk
Practice address
10 Shurs LN Ste 206
Philadelphia, PA 19127-2123
Phone
(215) 482-1234
Fax
(215) 482-0465
NPI assigned
Feb 13, 2020
Last updated
Jun 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Authorized official

Name
Charles Michael Valentino Jr.
Title
VP of Revenue Integrity
Phone
(484) 628-9380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X Primary

Addresses

Primary practice location

10 Shurs LN Ste 206
Philadelphia, PA 19127-2123

Mailing address

PO Box 13579
Reading, PA 19612-3579

Other names 1

  • SPORTS MEDICINE TOWER HEALTH MEDICAL GROUP MANAYUNK Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061117000409 PA Part B Supplier - Clinic/Group Practice 9335147784 Receives reassigned benefits from 49 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wyncote, PA; Phildelphia, PA; Philadelphia, PA; Flourtown, PA

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
County Intermediate Unit18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1306479829",
    "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": "10 SHURS LN STE 206",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191272123",
            "telephone_number": "215-482-1234",
            "fax_number": "215-482-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWER DREXEL ACADEMIC MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-13",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "VALENTINO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "VP OF REVENUE INTEGRITY",
        "authorized_official_telephone_number": "484-628-9380",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPORTS MEDICINE TOWER HEALTH MEDICAL GROUP MANAYUNK",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SPORTS MEDICINE TOWER HEALTH MEDICAL GROUP MANAYUNK",
            "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 Jun 2, 2026; 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.