Individual provider Active NPI

Pamela Ann Fenstemacher, M.D.

  • Family Medicine Physician
  • Jenkintown, PA
National Provider Identifier
1366471179
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD043780E Issued in PA
Practice address
500 York Rd
Suite #108
Jenkintown, PA 19046-2852
Phone
(215) 481-2725
NPI assigned
Jul 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD043780E PA Primary

Addresses

Primary practice location

500 York Rd
Suite #108
Jenkintown, PA 19046-2852

Mailing address

4508 Chestnut St
Philadelphia, PA 19139-3608
Phone (215) 573-7200

Other identifiers 1

IdentifierTypeStateIssuer
1288936MedicaidPA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150615000484 PA Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 0345370540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1366471179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4508 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393608",
            "telephone_number": "215-573-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 YORK RD",
            "address_2": "SUITE #108",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462852",
            "telephone_number": "215-481-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENSTEMACHER",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD043780E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1288936",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenkintown, PA

Sources for this page

Verify at the official NPI Registry.