NPIMap

Organization Active NPI

Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
National Provider Identifier
1306514138
Registry record updated Sep 7, 2021
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
4601 Market St
Philadelphia, PA 19139-4636
Phone
(215) 985-2500
Fax
(267) 765-2325
NPI assigned
Sep 7, 2021
Last updated
Sep 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Authorized official

Name
Frank Killian
Title
Dir-Finance and Regulatory Affairs
Phone
(215) 985-2514

Specialties & licenses 1

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

Addresses

Primary practice location

4601 Market St
Philadelphia, PA 19139-4636

Mailing address

1500 Market St.
Centre SQ East 17TH FLR Attn: D. Pritchard
Philadelphia, PA 19102
Phone (215) 731-2406

Other names 1

  • PHMC Health Center at 4601 Market 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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306514138. Details of each certification follow.

  • CCN 731954 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 731954

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
PHMC HEALTH CENTER AT 4601 MARKET
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 1, 2022
Last certification
Feb 1, 2022
Ownership / control type
For profit – corporation
Facility address
4601 Market St
Philadelphia, PA 19139

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1630972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630972800000",
    "number": "1306514138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MARKET ST.",
            "address_2": "CENTRE SQ EAST 17TH FLR ATTN: D. PRITCHARD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-731-2406",
            "fax_number": "267-765-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191394636",
            "telephone_number": "215-985-2500",
            "fax_number": "267-765-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HEALTH MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "KILLIAN",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "DIR-FINANCE AND REGULATORY AFFAIRS",
        "authorized_official_telephone_number": "215-985-2514"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHMC Health Center at 4601 Market",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.