NPIMap

Organization Active NPI

Pottstown Medical Specialists Inc

  • Family Medicine Physician
  • Royersford, PA
National Provider Identifier
1376667790
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS008179L Issued in PA
Legal business name
POTTSTOWN MEDICAL SPECIALISTS INC
Practice address
307 South Lewis Road
Royersford, PA 19468
Phone
(610) 792-0300
Fax
(610) 792-3790
NPI assigned
Mar 19, 2007
Organization subpart
Yes
Parent organization
POTTSTOWN MEDICAL SPECIALISTSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Authorized official

Name
Shana M Enochs
Title
Credentialing Specialist
Phone
(610) 327-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS008179L PA Primary

Addresses

Primary practice location

307 South Lewis Road
Royersford, PA 19468

Mailing address

1610 Medical Drive
Suite 310
Pottstown, PA 19464
Phone (610) 327-4200

Other identifiers 2

IdentifierTypeStateIssuer
26191OtherPABLUE SHIELD ASSIGN ACCT
0045725016OtherPAKEYSTONE HMO

Other names 1

  • Spring Ford Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040426000589 PA Part B Supplier - Clinic/Group Practice 8224024096 Receives reassigned benefits from 51 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boyertown, PA; Collegeville, PA; Pottstown, PA; Royersford, PA; Stowe, PA

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0961357Spring-Ford Family Practice307 South Lewis Road, Royersford, PA 19468Provider-performed microscopyJun 3, 2027

National Provider Directory

National Provider Directory
Part of
Stowe Medical Group

Locations

555 Second Ave
Ste 300
Collegeville, PA 19426
Phone (610) 454-7750

555 Second Ave
Ste C-300
Collegeville, PA 19426
Phone (610) 454-7750

1601 Medical Dr
Pottstown, PA 19464
Phone (610) 327-4200

307 S Lewis Rd
Royersford, PA 19468
Phone (610) 792-0300

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1376667790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 MEDICAL DRIVE",
            "address_2": "SUITE 310",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "19464",
            "telephone_number": "610-327-4200",
            "fax_number": "610-327-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 SOUTH LEWIS ROAD",
            "city": "ROYERSFORD",
            "state": "PA",
            "postal_code": "19468",
            "telephone_number": "610-792-0300",
            "fax_number": "610-792-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTSTOWN MEDICAL SPECIALISTS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POTTSTOWN MEDICAL SPECIALISTS",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "ENOCHS",
        "authorized_official_first_name": "SHANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "610-327-4200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS008179L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ASSIGN ACCT",
            "identifier": "26191",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HMO",
            "identifier": "0045725016",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spring Ford Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Royersford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.