NPIMap

Organization Active NPI

Tower Drexel Academic Medical Group LLC

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1407499148
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
TOWER DREXEL ACADEMIC MEDICAL GROUP LLC
Practice address
160 E Erie Ave FL 2
Philadelphia, PA 19134-1011
Phone
(610) 743-6049
NPI assigned
Oct 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Authorized official

Name
Charles Michael Valentino Jr.
Title
VP of Revenue Integrity
Phone
(484) 628-9380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

160 E Erie Ave FL 2
Philadelphia, PA 19134-1011

Mailing address

PO Box 13579
Reading, PA 19612-3579

Other practice location 1

160 E Erie Ave Fl 3
Philadelphia, PA 19134-1011
Phone (215) 427-5000

Other identifiers 2

IdentifierTypeStateIssuer
1017628220007MedicaidPA
1017628220015MedicaidPA

Other names 1

  • PSYCHIATRY TOWER HEALTH MEDICAL GROUP ERIE AVENUE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061117000409 PA Part B Supplier - Clinic/Group Practice 9335147784 Receives reassigned benefits from 49 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wyncote, PA; Phildelphia, PA; Philadelphia, PA; Flourtown, PA

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
County Intermediate Unit18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 5

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": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1407499148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "610-743-6049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 E Erie Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191341011",
            "country_code": "US",
            "telephone_number": "215-427-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TOWER DREXEL ACADEMIC MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-25",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "VALENTINO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "VP OF REVENUE INTEGRITY",
        "authorized_official_telephone_number": "484-628-9380",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017628220007",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017628220015",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PSYCHIATRY TOWER HEALTH MEDICAL GROUP ERIE AVENUE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 2, 2026; 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.