NPIMap

Organization Active NPI

Trinity Health Mid-Atlantic Medical Group

Doing business as Diabetes Management Center

  • Registered Dietitian
  • Langhorne, PA
National Provider Identifier
1366949646
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP
Doing business as
Diabetes Management Center
St Mary Diabetes Management Center
St. Mary Diabetes Management Center
Practice address
1205 Langhorne Newtown Rd Ste 302
Langhorne, PA 19047-1222
Phone
(215) 710-5812
Fax
(215) 710-6801
NPI assigned
Apr 12, 2018
Last updated
Sep 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Authorized official

Name
Julie Keese
Title
VP, Finance and Cfo
Phone
(301) 754-7201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X PA Primary

Addresses

Primary practice location

1205 Langhorne Newtown Rd Ste 302
Langhorne, PA 19047-1222

Mailing address

1201 Langhorne Newtown Rd
Mail Room
Langhorne, PA 19047-1201
Phone (215) 710-5522

Other names 3

  • Diabetes Management Center Doing business as
  • St Mary Diabetes Management Center Doing business as
  • St. Mary Diabetes Management Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobus Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326000613 PA Part B Supplier - Clinic/Group Practice 7416861885 Receives reassigned benefits from 703 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Langhorne Phys SVCS Pat38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

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

View all 37

Locations

1205 Langhorne Newtown Rd
Ste 301
Langhorne, PA 19047
Phone (215) 757-1414

1205 Langhorne Newtown Rd
Ste 400
Langhorne, PA 19047
Phone (215) 710-2633

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790640000000",
    "number": "1366949646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 LANGHORNE NEWTOWN RD",
            "address_2": "MAIL ROOM",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471201",
            "telephone_number": "215-710-5522",
            "fax_number": "215-710-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 LANGHORNE NEWTOWN RD STE 302",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471222",
            "telephone_number": "215-710-5812",
            "fax_number": "215-710-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-12",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A",
        "authorized_official_last_name": "KEESE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "VP, FINANCE AND CFO",
        "authorized_official_telephone_number": "301-754-7201"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobus Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Diabetes Management Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Mary Diabetes Management Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Mary Diabetes Management Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Mary Diabetes Management Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Langhorne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.