NPIMap

Organization Active NPI

Northwestern Medical Associates PC

  • Internal Medicine Physician
  • Fort Washington, PA
National Provider Identifier
1407806003
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTHWESTERN MEDICAL ASSOCIATES PC
Practice address
7170 Lafayette Ave
Fort Washington, PA 19034-2301
Phone
(215) 641-5300
NPI assigned
May 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Richard Jay Leavitt, D.O.
Title
President
Phone
(215) 542-4343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

7170 Lafayette Ave
Fort Washington, PA 19034-2301

Mailing address

589 Skippack Pike
Suite 308
Blue Bell, PA 19422-2159
Phone (215) 542-4343

Other identifiers 1

IdentifierTypeStateIssuer
0015622660005MedicaidPA

National Provider Directory

National Provider Directory

Locations

589 Skippack Pike
Blue Bell, PA 19422

589 Skippack Pike
Ste 309
Blue Bell, PA 19422

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407806003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 SKIPPACK PIKE",
            "address_2": "SUITE 308",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222159",
            "telephone_number": "215-542-4343",
            "fax_number": "215-542-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7170 LAFAYETTE AVE",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342301",
            "telephone_number": "215-641-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEAVITT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-542-4343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015622660005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.