Organization Active NPI

Elwyn of Pennsylvania and Delaware

  • Local Education Agency (LEA)
  • Philadelphia, PA
National Provider Identifier
1487768123
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Legal business name
ELWYN OF PENNSYLVANIA AND DELAWARE
Practice address
4025 Chestnut St
Philadelphia, PA 19104-3054
Phone
(215) 222-5066
Fax
(215) 222-5143
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Authorized official

Name
Donna K Busch
Title
Payer Contract Manager
Phone
(610) 639-6932

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X PA Primary

Addresses

Primary practice location

4025 Chestnut St
Philadelphia, PA 19104-3054

Mailing address

4025 Chestnut St
Philadelphia, PA 19104-3054
Phone (215) 222-5066

Other practice location 1

419 Avenue Of The States Fl 3
Chester, PA 19013-4451
Phone (215) 222-8054

Other identifiers 1

IdentifierTypeStateIssuer
1000021240225MedicaidPA

Other names 2

  • Elwyn Early Learning Services Philadelphia Doing business as
  • Early Learning Services-Chester Upland Other name

National Provider Directory

National Provider Directory
Tax ID family
Elwyn Medical Services61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

419 Avenue of the States
Fl 3
Chester, PA 19013
Phone (215) 222-8054

4025 Chestnut St
Philadelphia, PA 19104
Phone (267) 225-6714

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1487768123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043054",
            "telephone_number": "215-222-5066",
            "fax_number": "215-222-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043054",
            "telephone_number": "215-222-5066",
            "fax_number": "215-222-5143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "419 Avenue Of The States Fl 3",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "PA",
            "postal_code": "190134451",
            "country_code": "US",
            "telephone_number": "215-222-8054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELWYN OF PENNSYLVANIA AND DELAWARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "BUSCH",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PAYER CONTRACT MANAGER",
        "authorized_official_telephone_number": "610-639-6932"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000021240225",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elwyn Early Learning Services Philadelphia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Early Learning Services-Chester Upland",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.