Organization Active NPI

College Cardiology Associates, LTD

  • Cardiovascular Disease Physician
  • Bala Cynwyd, PA
National Provider Identifier
1497793806
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
OS006801E Issued in PA
Legal business name
COLLEGE CARDIOLOGY ASSOCIATES, LTD
Practice address
1 Bala Ave Ste 300
Bala Cynwyd, PA 19004-3207
Phone
(610) 660-9910
Fax
(610) 660-9920
NPI assigned
Jun 4, 2006
Last updated
Jul 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Authorized official

Name
Dr. Joseph S Kenney III, D.O.NPI 1750387544
Title
President
Phone
(215) 370-1292

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
Cardiovascular Disease Physician 207RC0000X OS006801E PA Primary

Addresses

Primary practice location

1 Bala Ave Ste 300
Bala Cynwyd, PA 19004-3207

Mailing address

One Bala Avenue
Suite 300
Bala Cynwyd, PA 19004
Phone (610) 660-9910

Other identifiers 1

IdentifierTypeStateIssuer
0011719890003MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080421000071 PA Part B Supplier - Clinic/Group Practice 1052499886 Receives reassigned benefits from 1 practitioner
Practice locations: Phila, PA; Philadelphia, PA; Bala Cynwyd, PA

National Provider Directory

National Provider Directory

Locations

1 Bala Ave
Ste 305
Bala Cynwyd, PA 19004
Phone (610) 660-9910

4190 City Ave
Ste 514
Philadelphia, PA 19131
Phone (215) 871-2660

5008 Baltimore Ave
Philadelphia, PA 19143
Phone (215) 724-5899

Practitioners & affiliated clinicians

Practitioners 9

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": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1497793806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE BALA AVENUE",
            "address_2": "SUITE 300",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "19004",
            "telephone_number": "610-660-9910",
            "fax_number": "610-660-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BALA AVE STE 300",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043207",
            "telephone_number": "610-660-9910",
            "fax_number": "610-660-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE CARDIOLOGY ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "KENNEY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-370-1292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OS006801E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011719890003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.