NPIMap

Organization Active NPI

Pulmonology Associates Inc

  • Pulmonary Disease Physician
  • Wynnewood, PA
National Provider Identifier
1437180742
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PULMONOLOGY ASSOCIATES INC
Practice address
100 E Lancaster Ave
Suite 230
Wynnewood, PA 19096-3450
Phone
(610) 642-3796
Fax
(610) 642-2943
NPI assigned
Jul 5, 2006
Last updated
Jul 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Authorized official

Name
Donald Duane Peterson, MDNPI 1689610453
Title
President
Phone
(610) 642-3796

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
Pulmonary Disease Physician 207RP1001X Primary

Addresses

Primary practice location

100 E Lancaster Ave
Suite 230
Wynnewood, PA 19096-3450

Mailing address

100 E Lancaster Ave
Suite 230
Wynnewood, PA 19096-3450
Phone (610) 642-3796

Other identifiers 1

IdentifierTypeStateIssuer
0010768900007MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040602001367 PA Part B Supplier - Clinic/Group Practice 5698757763 Receives reassigned benefits from 24 practitioners
Practice locations: Paoli, PA; Wynnewood, PA

National Provider Directory

National Provider Directory

Locations

255 W Lancaster Ave
Ste 124
Paoli, PA 19301
Phone (610) 648-0553

100 E Lancaster Ave
Ste 230
Wynnewood, PA 19096
Phone (610) 642-3796

100 E Lancaster Ave
Ste 230W
Wynnewood, PA 19096

100 E Lancaster Ave
Ste W230
Wynnewood, PA 19096
Phone (610) 642-3796

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DJJDBA

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1437180742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 230",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-642-3796",
            "fax_number": "610-642-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 230",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-642-3796",
            "fax_number": "610-642-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONOLOGY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-642-3796",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010768900007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.