Individual provider Active NPI

Lori A. King, P.A.-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1356549265
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA053009 Issued in PA
Practice address
815 Griffith St
Philadelphia, PA 19111-2508
Phone
(267) 939-4715
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT001921E PA
Physician Assistant 363A00000X MA053009 PA Primary

Addresses

Primary practice location

815 Griffith St
Philadelphia, PA 19111-2508

Mailing address

815 Griffith St
Philadelphia, PA 19111-2508
Phone (267) 939-4715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070822000034 PA Practitioner - Physician Assistant 4587756697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Pennsylvania Physician Alliance, LLCGroup PAC ID 8325478662, 112 clinicians

Practice addresses (Care Compare)

4641 Roosevelt Blvd
Philadelphia, PA 19124-2343
Phone (215) 831-4600

722 E Butler Pike
Ambler, PA 19002-2310
Phone (215) 643-7800

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
78.42
Improvement activities
40
Cost
70.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PT001921EPAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alfred Stillman - Home Visit Doctors Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1356549265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 GRIFFITH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112508",
            "telephone_number": "267-939-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 GRIFFITH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112508",
            "telephone_number": "267-939-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "LORI",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "PA",
            "license": "PT001921E",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.