NPIMap

Organization Active NPI

Advocare , LLC

  • Pediatric Adolescent Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1386288702
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
ADVOCARE , LLC
Practice address
2000 Hamilton St Ste 109
Philadelphia, PA 19130-3847
Phone
(215) 774-1166
NPI assigned
Oct 29, 2019
Organization subpart
Yes
Parent organization
ADVOCARE , LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Authorized official

Name
Charles McQueary
Title
Executive VP and Coo
Phone
(856) 872-7052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X Primary

Addresses

Primary practice location

2000 Hamilton St Ste 109
Philadelphia, PA 19130-3847

Mailing address

PO Box 71422
Philadelphia, PA 19176-1422
Phone (856) 872-7055

Other names 1

  • Advocare Fairmount Pediatrics and Adolescent Medicine Other name

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
39D1105885Advocare Fairmount Pediatrics2000 Hamilton St, Suite 109, Philadelphia, PA 19130Certificate of waiverAug 3, 2026

National Provider Directory

National Provider Directory
Tax ID family
Advocare Chalfont Internal Medicine248 organizations share this tax ID, including this one
Part of
Advocare Chalfont Internal Medicine

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

120 E Lancaster Ave
#201
Ardmore, PA 19003

190 W Germantown Pike
Ste 150
Norristown, PA 19401
Phone (215) 774-1166

2000 Hamilton St
Ste 303
Philadelphia, PA 19130
Phone (215) 564-4880

Practitioners & affiliated clinicians

Practitioners 1

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": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1386288702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71422",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191761422",
            "telephone_number": "856-872-7055",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 HAMILTON ST STE 109",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303847",
            "telephone_number": "215-774-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCARE , LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOCARE , LLC",
        "enumeration_date": "2019-10-29",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "MCQUEARY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "EXECUTIVE VP AND COO",
        "authorized_official_telephone_number": "856-872-7052"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advocare Fairmount Pediatrics and Adolescent Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Advocare Fairmount Pediatrics and Adolescent Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.