Philly Medical and Rehab Associates

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS007133L Issued in PA

Legal business name

PHILLY MEDICAL AND REHAB ASSOCIATES

Practice address

6401 Rising Sun Ave
Philadelphia, PA 19111-5228

Phone

(215) 535-5616

Fax

(215) 535-5618

NPI assigned

Mar 14, 2018

Last updated

Jul 6, 2020By 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

Paul M Kosmorsky, DONPI 1518921691

Title

Owner

Phone

(215) 488-4999

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

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.

• Paul Michael Kosmorsky, D.O.

  • Family Medicine Physician
  • Yardley, PA
  • NPI 1518921691
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1376046508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191115228",
            "telephone_number": "215-535-5616",
            "fax_number": "215-535-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191115228",
            "telephone_number": "215-535-5616",
            "fax_number": "215-535-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLY MEDICAL AND REHAB ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-14",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "KOSMORSKY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-488-4999",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS007133L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "F27707",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philly Drugstore LLC
• Philly Family Life Counseling, LLC
• Philly Ifs Therapy, LLC
• Philly Injury Center, Inc.
• Philly Kids 'N Nurses
• Philly Metro Pharmacy LLC (philly metro pharmacy)
• Philly Newlife Suboxone Clinics
• Philly Pharmacy II, LLC (Philly Pharmacy)
• Philly Pharmacy LLC (Philly Pharmacy)
• Philly Pregnancy Center PC

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.