Mercy Management of Southeastern Pennsylvani

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANI

Doing business as

MMS-Mercy Fitzgerald Hospialist

Practice address

1500 Lansdowne Ave
Darby, PA 19023-1200

Phone

(610) 237-3698

Fax

(610) 237-2580

NPI assigned

Dec 20, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Douglas C Smith

Title

VP Financial Services

Phone

(610) 567-6964

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• MMS-Mercy Fitzgerald Hospialist Doing business as

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1508842691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "address_2": "2ND FLOOR",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282007",
            "telephone_number": "610-567-6964",
            "fax_number": "610-567-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LANSDOWNE AVE",
            "city": "DARBY",
            "state": "PA",
            "postal_code": "190231200",
            "telephone_number": "610-237-3698",
            "fax_number": "610-237-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANI",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP FINANCIAL SERVICES",
        "authorized_official_telephone_number": "610-567-6964",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "2233321000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2341239",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7202146",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY HEALTH PLA",
            "identifier": "30011099",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007787930151",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1549250",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA  PPO",
            "identifier": "7202146",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMS-Mercy Fitzgerald Hospialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mercy Management of Sepa (SEPA Midlevel Practioners)
• Mercy Management of Sepa (MMS-Mercy Interventional Cardiology)
• Mercy Management of Sepa (MMS-Richard Kanoff, DO)
• Mercy Management of Sepa (MMS-Mercy Gynecologic Associates)
• Mercy Management of Sepa (MMSEPA Radiation Oncology)
• Mercy Management of Southeastern Pennsylvani
• Mercy Management of Southeastern Pennsylvania (Mercy Fitzgearld Cardiology Associates)
• Mercy Management of Southeastern Pennsylvania
• Mercy Management of Southeastern Pennsylvania
• Mercy Management of Southeastern Pennsylvania (Mercy Fitzgerald Surgical Associates)

• Internal Medicine Physician in Darby, PA
• Providers in Darby, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.