Academic Urology of PA, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

50421501 Issued in PA

Legal business name

ACADEMIC UROLOGY OF PA, LLC

Practice address

919 Conestoga Rd
Building 1 Suite 300
Bryn Mawr, PA 19010-1352

Phone

(610) 525-6580

Fax

(610) 525-3664

NPI assigned

Apr 8, 2011

Last updated

Apr 3, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David J Ellis, M.D.NPI 1306896279

Title

President

Phone

(610) 382-5910

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA4 enrollments

Enrollment records 4

Listed as

Academic Urology of PA LLC Bryn Mawr Urology GroupCCN 39C0001299

Medicare certification status

ActiveFrom the Provider of Services file

Listed as

The Centers for Advanced Urology LLC Dba Urology Center of Chester County PaoliCCN 39C0001340

Medicare certification status

ActiveFrom the Provider of Services file

Listed as

Academic Urology of PA LLC Dba Associates in UrologyCCN 39C0001337

Medicare certification status

ActiveFrom the Provider of Services file

Listed as

Academic Urology of PA LLC Dba Tri County UrologyCCN 39C0001313

Medicare certification status

ActiveFrom the Provider of Services file

Listed as

The Centers for Advanced Urology LLC Dba Urology Center of Chester CountyCCN 39C0001316

Medicare certification status

Terminated Voluntary: merger or closure, Nov 9, 2023From the Provider of Services file

Tax ID family

Academic Urology of PA LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Academic Urology of PA, LLC

  • Urology Physician
  • East Norriton, PA
  • NPI 1275841975
  NPD tax ID
• Academic Urology of PA, LLC

  • Radiation Oncology Physician
  • King of Prussia, PA
  • NPI 1366799140
  NPD tax ID
• Academic Urology of PA, LLC

  • Urology Physician
  • Lansdale, PA
  • NPI 1417288150
  NPD tax ID
• Academic Urology of PA,LLC

  • Urology Physician
  • Norristown, PA
  • NPI 1003148966
  NPD tax ID

Member of 2

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

• Alliance Physician Services, PC

  dba MidLantic Urology

  • Urology Physician
  • Paoli, PA
  • NPI 1952829350

  Member Of

  NPD member
• Center for Advanced Urology

  • Urology Physician
  • Salem, NJ
  • NPI 1598720443

  Member Of

  NPD member

Locations

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.

• Lawrence M Lee, M.D.

  • Urology Physician
  • Pottstown, PA
  • NPI 1760740062
  Medicare reassignment NPD
• Peter O Oskanian, MD

  • Urology Physician
  • Pottstown, PA
  • NPI 1487764486
  Medicare reassignment NPD
• Matthew E Sterling, MD

  • Urology Physician
  • Bryn Mawr, PA
  • NPI 1891056792
  Medicare reassignment NPD
• David J Ellis, M.D.

  • Urology Physician
  • Rosemont, PA
  • NPI 1306896279
  Authorized official Same address or phone
• Amanda Cappuccino, PA-C

  • Physician Assistant
  • West Chester, PA
  • NPI 1558195800
  NPD (past)

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1336439645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S GULPH RD",
            "address_2": "SUITE 200",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063112",
            "telephone_number": "610-382-5910",
            "fax_number": "610-382-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 CONESTOGA RD",
            "address_2": "BUILDING 1 SUITE 300",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101352",
            "telephone_number": "610-525-6580",
            "fax_number": "610-525-3664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Old Fern Hill Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "PA",
            "postal_code": "193803431",
            "country_code": "US",
            "telephone_number": "610-692-4270",
            "fax_number": "610-692-2566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Industrial Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Paoli",
            "state": "PA",
            "postal_code": "193011645",
            "country_code": "US",
            "telephone_number": "610-644-2165",
            "fax_number": "610-644-2165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 N Sunnybrook Rd",
            "address_purpose": "LOCATION",
            "city": "Pottstown",
            "state": "PA",
            "postal_code": "194642946",
            "country_code": "US",
            "telephone_number": "610-935-9010",
            "fax_number": "610-935-1510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 E State St Ste 205",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "190633434",
            "country_code": "US",
            "telephone_number": "610-565-2776",
            "fax_number": "610-565-4247",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 Andrew Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "PA",
            "postal_code": "193803446",
            "country_code": "US",
            "telephone_number": "610-692-4270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ACADEMIC UROLOGY OF PA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-08",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-382-5910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "50421501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Abramowitz
• Abramson Center for Jewish Life Medical Group
• Andrew Abramson, LMT
• Stacy Abramson, CFNC
• Academic Urology of PA LLC
• Acorn Child Development and Evaluation, LLC
• Megan Adams
• Raymond Adams, MD
• Susan C Adelman, PH.D.
• Taiwo Aderibigbe, MD

• Ambulatory Surgical Clinic/Center in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.