NPIMap

Organization Active NPI

Fornance Physician Services Inc

Doing business as Einstein Physicians Montgomery

  • Clinical Social Worker
  • Lansdale, PA
National Provider Identifier
1316608540
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FORNANCE PHYSICIAN SERVICES INC
Doing business as
Einstein Physicians Montgomery
Practice address
2010 N Broad St Ste 100
Lansdale, PA 19446-1004
Phone
(484) 622-7500
NPI assigned
Jan 10, 2022
Last updated
Jan 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Vera Burnett-Robins
Title
Director
Phone
(484) 622-7399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

2010 N Broad St Ste 100
Lansdale, PA 19446-1004

Mailing address

PO Box 789967
Philadelphia, PA 19178-1004
Phone (484) 622-7395

Other identifiers 1

IdentifierTypeStateIssuer
1041C0700XOtherLICENSED SOCIAL WORKER

Other names 1

  • Einstein Physicians Montgomery Doing business as

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL http://www.einstein.edu/locations/outpatient/lansdale
CONNECT URL http://www.einstein.edu/locations/outpatient/lansdale
CONNECT URL http://www.einstein.edu/locations/outpatient/lansdale

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000037 PA Part B Supplier - Clinic/Group Practice 8527962661 Receives reassigned benefits from 215 practitioners
36 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: King of Prussia, PA; Lansdale, PA; Norristown, PA; North Wales, PA; Plymouth Meeting, PA; East Norriton, PA; Audubon, PA; Blue Bell, PA…

Other NPIs on the same Medicare enrollment 36

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

View all 36

National Provider Directory

National Provider Directory
Tax ID family
Fornance Physician Services Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Practitioners & affiliated clinicians

Practitioners 6

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": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1316608540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 789967",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191781004",
            "telephone_number": "484-622-7395",
            "fax_number": "484-622-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 N BROAD ST STE 100",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194461004",
            "telephone_number": "484-622-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORNANCE PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "BURNETT-ROBINS",
        "authorized_official_first_name": "VERA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "484-622-7399"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED SOCIAL WORKER",
            "identifier": "1041C0700X",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.einstein.edu/locations/outpatient/lansdale",
            "affiliation": "N",
            "address_1": "2010 N Broad St Ste 100",
            "city": "Lansdale",
            "state": "PA",
            "country_code": "US",
            "postal_code": "194461004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.einstein.edu/locations/outpatient/lansdale",
            "affiliation": "N",
            "address_1": "2010 N Broad St Ste 100",
            "city": "Lansdale",
            "state": "PA",
            "country_code": "US",
            "postal_code": "194461004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.einstein.edu/locations/outpatient/lansdale",
            "affiliation": "N",
            "address_1": "2010 N Broad St Ste 100",
            "city": "Lansdale",
            "state": "PA",
            "country_code": "US",
            "postal_code": "194461004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Einstein Physicians Montgomery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lansdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.