NPIMap

Organization Active NPI

Drexel Hill Pediatric Associates

  • Pediatric Adolescent Medicine Physician
  • Springfield, PA
National Provider Identifier
1477680874
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
DREXEL HILL PEDIATRIC ASSOCIATES
Practice address
400 S State Rd Ste 210
Springfield, PA 19064-1243
Phone
(610) 623-9080
Fax
(610) 623-3861
NPI assigned
Feb 27, 2007
Last updated
Oct 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Authorized official

Name
Dr. Matthew Brandon McCarthy, MDNPI 1740424977
Title
Vice President
Phone
(610) 623-9080

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
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X Primary

Addresses

Primary practice location

400 S State Rd Ste 210
Springfield, PA 19064-1243

Mailing address

400 S State Rd Ste 210
Springfield, PA 19064-1243
Phone (610) 623-9080

Other identifiers 1

IdentifierTypeStateIssuer
0010976940003MedicaidPA

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
39D0195779Drexel Hill Pediatric Associates400 S State Road, Suite 210, Springfield, PA 19064Certificate of waiverJun 30, 2028

National Provider Directory

National Provider Directory

Locations

5030 State Rd
Ste 2-900
Drexel Hill, PA 19026
Phone (610) 623-9080

400 S State Rd
Ste 210
Springfield, PA 19064
Phone (610) 623-9080

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1477680874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S STATE RD STE 210",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190641243",
            "telephone_number": "610-623-9080",
            "fax_number": "610-623-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S STATE RD STE 210",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190641243",
            "telephone_number": "610-623-9080",
            "fax_number": "610-623-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREXEL HILL PEDIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "BRANDON",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "610-623-9080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010976940003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.