NPIMap

Organization Active NPI

The Pennsylvania Hospital of the University of Pennsylvania Health Sys

Doing business as Pennsylvania Hospital

  • Endoscopy Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1477808459
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
Legal business name
THE PENNSYLVANIA HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA HEALTH SYS
Doing business as
Pennsylvania Hospital
Practice address
230 W Washington SQ
Farm Journal Building, 4TH Floor
Philadelphia, PA 19106-3500
Phone
(215) 829-3561
NPI assigned
Jul 17, 2012
Last updated
Jun 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

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

Authorized official

Name
Thomas McCormick Sr.
Title
Avp
Phone
(215) 762-0888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X NU Primary

Addresses

Primary practice location

230 W Washington SQ
Farm Journal Building, 4TH Floor
Philadelphia, PA 19106-3500

Mailing address

230 W Washington SQ
Farm Journal Building, 4TH Floor
Philadelphia, PA 19106-3500
Phone (215) 829-3561

Other names 1

  • Pennsylvania Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130719000047 PA Part B Supplier - Ambulatory Surgical Center 6305927229 Practice locations: Philadelphia, PA

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Endoscopy Center of Pennsylania HospitalCCN 39C0001133
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Pennsylvania Hospital of the University of Pennsylvania Health System14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

230 W Washington Sq
Bldg 4TH
Philadelphia, PA 19106
Phone (215) 829-3561

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Pennsylvania Hospital of the University of Pennsylvania Health SysPhiladelphia, PA, CCN 390226 Hospital Operational/Managerial Control Apr 30, 1997
The Pennsylvania Hospital of the University of Pennsylvania Health SysPhiladelphia, PA, CCN 39S226 Hospital Operational/Managerial Control Apr 30, 1997

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372291200000",
    "number": "1477808459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W WASHINGTON SQ",
            "address_2": "FARM JOURNAL BUILDING, 4TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063500",
            "telephone_number": "215-829-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W WASHINGTON SQ",
            "address_2": "FARM JOURNAL BUILDING, 4TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063500",
            "telephone_number": "215-829-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PENNSYLVANIA HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA HEALTH SYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2013-06-27",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "AVP",
        "authorized_official_telephone_number": "215-762-0888",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pennsylvania Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.