NPIMap

Organization Active NPI

Montco Wound and Primary Care Center PC

  • Adult Medicine Physician
  • King of Prussia, PA
National Provider Identifier
1376351965
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
MONTCO WOUND AND PRIMARY CARE CENTER PC
Practice address
583 Shoemaker Rd
King of Prussia, PA 19406-4201
Phone
(484) 378-2424
Fax
(484) 723-5324
NPI assigned
Dec 27, 2024
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Anthony Michael Letizio, DO
Title
Authorized Official
Phone
(484) 378-2424

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250411002085 PA Part B Supplier - Clinic/Group Practice 0244754166 Receives reassigned benefits from 6 practitioners
Practice locations: Philadelphia, PA; King of Prussia, PA

National Provider Directory

National Provider Directory

Specialties & licenses 5

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X

Addresses

NPPES NPI Registry

Primary practice location

583 Shoemaker Rd
King of Prussia, PA 19406-4201

Mailing address

583 Shoemaker Rd
King of Prussia, PA 19406-4201
Phone (484) 378-2424

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 25, 2025.

{
    "created_epoch": "1735257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1376351965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "583 SHOEMAKER RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194064201",
            "telephone_number": "484-378-2424",
            "fax_number": "484-723-5324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "583 SHOEMAKER RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194064201",
            "telephone_number": "484-378-2424",
            "fax_number": "484-723-5324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTCO WOUND AND PRIMARY CARE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-27",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "LETIZIO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "484-378-2424",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.