NPIMap

Organization Active NPI

Mercy Catholic Medical Center of Southeastern PA

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1437130705
Registry record updated Jan 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA
Practice address
1503 Lansdowne Avenue
Suite 2000
Philadelphia, PA 19143-1900
Phone
(610) 237-3646
Fax
(610) 237-4261
NPI assigned
Nov 14, 2005
Last updated
Jan 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2018

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

Authorized official

Name
Phyllis Hilker
Title
V.P. Finance
Phone
(610) 567-6967

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X

Addresses

Primary practice location

1503 Lansdowne Avenue
Suite 2000
Philadelphia, PA 19143-1900

Mailing address

1 W Elm St
Suite 100
Conshohocken, PA 19428-4108
Phone (610) 567-6967

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408000889 PA Part B Supplier - Clinic/Group Practice 3678476561 Receives reassigned benefits from 37 practitioners
2 other NPIs on this enrollment
Practice locations: Darby, PA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Mercy Hospital Phy GRP19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 37

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 37

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517270400000",
    "number": "1437130705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "address_2": "SUITE 100",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194284108",
            "telephone_number": "610-567-6967",
            "fax_number": "610-567-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 LANSDOWNE AVENUE",
            "address_2": "SUITE 2000",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431900",
            "telephone_number": "610-237-3646",
            "fax_number": "610-237-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-14",
        "last_updated": "2018-01-30",
        "status": "A",
        "authorized_official_last_name": "HILKER",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "V.P. FINANCE",
        "authorized_official_telephone_number": "610-567-6967"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jan 30, 2018; 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.