Individual provider Active NPI

Casey Elizabeth Lafferty, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1578874913
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS021947 Issued in PA
Practice address
700 Spruce St
Philadelphia, PA 19106-4022
Phone
(215) 829-3468
NPI assigned
Jun 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS13913 FL
Family Medicine Physician 207Q00000X OS021947 PA Primary

Addresses

Primary practice location

700 Spruce St
Philadelphia, PA 19106-4022

Mailing address

700 Spruce St
Philadelphia, PA 19106-4022
Phone (215) 829-3468

Other practice location 1

7000 Spyglass Ct Ste 200
Melbourne, FL 32940-7948
Phone (321) 728-6072

Other identifiers 2

IdentifierTypeStateIssuer
018283200MedicaidFL
IR340YOtherFLMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230204000254 PA Practitioner - Family Practice 7719104785 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS13913FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Sep 21, 2022 Accepting new patients
University of Penn - Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Sep 21, 2022 Accepting new patients
Trustees of the University of Pennsylvania Family Medicine CurrentSince Apr 1, 2024 Accepting new patients

Locations

700 Spruce St
Philadelphia, PA 19106
Phone (215) 829-3001

700 Spruce St
Ste 305
Philadelphia, PA 19106
Phone (215) 829-2092

3701 Market St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-2250

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1578874913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064022",
            "telephone_number": "215-829-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064022",
            "telephone_number": "215-829-3468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000 Spyglass Ct Ste 200",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329407948",
            "country_code": "US",
            "telephone_number": "321-728-6072",
            "fax_number": "321-252-1211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAFFERTY",
        "first_name": "CASEY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS13913",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS021947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018283200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IR340Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.