NPIMap

Organization Active NPI

Mercy Pediatric Associates PC

Doing business as Lansdowne Park Pediatrics

  • Pediatrics Physician
  • Darby, PA
National Provider Identifier
1417922782
Registry record updated Jul 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MERCY PEDIATRIC ASSOCIATES PC
Doing business as
Lansdowne Park Pediatrics
Practice address
1503 Lansdowne Ave
Ste 3002
Darby, PA 19023
Phone
(610) 237-4995
Fax
(610) 237-7311
NPI assigned
Feb 21, 2006
Last updated
Jul 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2011

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

Authorized official

Name
Jacqueline Genova, MDNPI 1164497947
Title
President
Phone
(610) 237-4995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

1503 Lansdowne Ave
Ste 3002
Darby, PA 19023

Mailing address

1503 Lansdowne Ave
Ste 3002
Darby, PA 19023
Phone (610) 237-4995

Other identifiers 5

IdentifierTypeStateIssuer
0014441550002MedicaidPA
0297647OtherCIGNA
0464621001OtherIBC
634564OtherBS
0018123OtherUSHC

Other names 1

  • Lansdowne Park Pediatrics Doing business as

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
39D0670184Mercy Pediatric Associates1503 Lansdowne Avenue Suite 3002, Darby, PA 19023Certificate of waiverOct 16, 2026

National Provider Directory

National Provider Directory

Locations

1503 Lansdowne Ave
Ste 3002
Darby, PA 19023
Phone (610) 237-4973

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309651200000",
    "number": "1417922782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 LANSDOWNE AVE",
            "address_2": "STE 3002",
            "city": "DARBY",
            "state": "PA",
            "postal_code": "19023",
            "telephone_number": "610-237-4995",
            "fax_number": "610-237-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 LANSDOWNE AVE",
            "address_2": "STE 3002",
            "city": "DARBY",
            "state": "PA",
            "postal_code": "19023",
            "telephone_number": "610-237-4995",
            "fax_number": "610-237-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY PEDIATRIC ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2011-07-03",
        "status": "A",
        "authorized_official_last_name": "GENOVA",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-237-4995",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014441550002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0297647",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "0464621001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "634564",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USHC",
            "identifier": "0018123",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lansdowne Park Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Darby, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2011; 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.