NPIMap

Organization Active NPI

Hospital of University of Pennsylvania

  • Adult Mental Health Clinic/Center
  • Phila, PA
National Provider Identifier
1487865036
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
HOSPITAL OF UNIVERSITY OF PENNSYLVANIA
Practice address
3400 Spruce St
Phila, PA 19104-4206
Phone
(215) 349-5150
Fax
(215) 615-0432
NPI assigned
May 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Authorized official

Name
Mr. Thomas McCormick
Title
Asst Vice President Finance
Phone
(215) 662-2709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

3400 Spruce St
Phila, PA 19104-4206

Mailing address

3101 Market St
Suite 160
Philadelphia, PA 19104-2807
Phone (215) 349-5150

Other identifiers 1

IdentifierTypeStateIssuer
1001258770208MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

National Provider Directory

National Provider Directory
Tax ID family
Univ of Penn Dept of NE44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680825600000",
    "number": "1487865036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 MARKET ST",
            "address_2": "SUITE 160",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042807",
            "telephone_number": "215-349-5150",
            "fax_number": "215-615-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-349-5150",
            "fax_number": "215-615-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL OF UNIVERSITY OF PENNSYLVANIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "ASST VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "215-662-2709",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001258770208",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; 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.