NPIMap

Organization Active NPI

Merakey Parkside Recovery

  • Community/Behavioral Health Agency
  • Philadelphia, PA
National Provider Identifier
1386869857
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MERAKEY PARKSIDE RECOVERY
Practice address
4806 Frankford Ave FL 2
Philadelphia, PA 19124-2606
Phone
(215) 836-3131
Fax
(215) 273-5975
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Authorized official

Name
Mr. Norman E Tilson Jr.
Title
Corp Sr. Director of Business Ops
Phone
(215) 836-3131

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4806 Frankford Ave FL 2
Philadelphia, PA 19124-2606

Mailing address

620 Germantown Pike
Lafayette Hill, PA 19444-1810
Phone (215) 836-3131

Other identifiers 2

IdentifierTypeStateIssuer
1007603690013MedicaidPA
1007603690015MedicaidPA

Other names 1

  • NHS Parkside Recovery Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120416000038 PA Part B Supplier - Clinic/Group Practice 2163683327 Receives reassigned benefits from 9 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Merakey Parkside Recovery9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

4806 Frankford Ave
Fl 2
Philadelphia, PA 19124

Practitioners & affiliated clinicians

Practitioners 2

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703635200000",
    "number": "1386869857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 GERMANTOWN PIKE",
            "city": "LAFAYETTE HILL",
            "state": "PA",
            "postal_code": "194441810",
            "telephone_number": "215-836-3131",
            "fax_number": "215-273-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4806 FRANKFORD AVE FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242606",
            "telephone_number": "215-836-3131",
            "fax_number": "215-273-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERAKEY PARKSIDE RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "TILSON",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CORP SR. DIRECTOR OF BUSINESS OPS",
        "authorized_official_telephone_number": "215-836-3131",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007603690013",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007603690015",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NHS Parkside Recovery",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "NHS Parkside Recovery",
            "code": "4",
            "type": "Former Legal Business 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 Dec 27, 2023; 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.