Organization Active NPI

Metro Physical Medicine Group Inc.

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
National Provider Identifier
1427428903
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
METRO PHYSICAL MEDICINE GROUP INC.
Practice address
2913 N 22ND St
Philadelphia, PA 19132-1505
Phone
(215) 613-4126
NPI assigned
Sep 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Authorized official

Name
Joe Cole
Title
Cfo
Phone
(215) 422-3140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

2913 N 22ND St
Philadelphia, PA 19132-1505

Mailing address

2913-15 NTH 22ND
Philadelphia, PA 19132-2009
Phone (215) 422-3140

Other identifiers 2

IdentifierTypeStateIssuer
1028115650002MedicaidPA
2880704OtherPABCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160705002018 PA Part B Supplier - Clinic/Group Practice 0446542856 Receives reassigned benefits from 3 practitioners
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

2913 N 22nd St
Philadelphia, PA 19132
Phone (215) 422-3109

Practitioners & affiliated clinicians

Practitioners 6

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": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1427428903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2913-15 NTH 22ND",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191322009",
            "telephone_number": "215-422-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2913 N 22ND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191321505",
            "telephone_number": "215-613-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO PHYSICAL MEDICINE GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-28",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "215-422-3140"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028115650002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2880704",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 May 20, 2016; 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.