NPIMap

Organization Active NPI

Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
National Provider Identifier
1568819084
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
PROSPECT HEALTH ACCESS NETWORK, INC.
Practice address
1 Medical Center Blvd
3Rd Floor
Chester, PA 19013-3902
Phone
(215) 447-2000
Fax
(610) 617-6260
NPI assigned
May 16, 2016
Last updated
Jan 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Authorized official

Name
Robert Jon Elders
Title
Secretary
Phone
(714) 788-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

1 Medical Center Blvd
3Rd Floor
Chester, PA 19013-3902

Mailing address

1 Medical Center Blvd
3Rd Floor
Chester, PA 19013-3902
Phone (215) 447-2000

Other names 1

  • HAN Emergency Physicians Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160613000737 PA Part B Supplier - Clinic/Group Practice 5698065142 Receives reassigned benefits from 730 practitioners
25 other NPIs on this enrollment

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 761

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.

View all 761

NPI Registry JSON

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610668800000",
    "number": "1568819084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "address_2": "3RD FLOOR",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "215-447-2000",
            "fax_number": "610-617-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "address_2": "3RD FLOOR",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "215-447-2000",
            "fax_number": "610-617-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT HEALTH ACCESS NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-16",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A",
        "authorized_official_last_name": "ELDERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "714-788-1249"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAN Emergency Physicians",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "HAN Emergency Physicians",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.