NPIMap

Mercy Catholic Medical Center of Southeastern PA

Organization Active NPI Internal Medicine Physician · Philadelphia, PA

NPI 1437130705 · NPPES record last updated Jan 30, 2018

Key facts

NPI
1437130705
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 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
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 2

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

Corporate family (same tax ID) 18

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

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 37

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

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

National Provider Directory

Tax ID family
Psychiatry Mercy Cath M (19 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X Yes
Psychiatry Physician
Group: 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

Other identifiers

IdentifierTypeStateIssuer
025024OtherPAHEALTHPARTNERS
30001873OtherPAKMHP
G0006731OtherPAAMERICHOICE
372921OtherPAHIGHMARK BLUE SHIELD
0114720000OtherPAKHPE
G0007408OtherPAAMERICHOICE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 30, 2018.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "025024",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KMHP",
            "identifier": "30001873",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "G0006731",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "372921",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHPE",
            "identifier": "0114720000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "G0007408",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Internal Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.