Mercy Management of Southeastern Pennsylvania

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA

Doing business as

Mercy Medical Associates at Providence

Practice address

831 Providence Rd
Secane, PA 19018-2921

Phone

(610) 934-1234

Fax

(610) 934-4811

NPI assigned

Oct 24, 2005

Last updated

Mar 20, 2008By the provider in NPPES

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 6

Other names 1

• Mercy Medical Associates at Providence Doing business as

Practitioners 7

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.

• Ruth M Arnold, DO

  • Internal Medicine Physician
  • Secane, PA
  • NPI 1023203544
  NPD (past)
• Andrew G Bongiovanni, DO

  • Internal Medicine Physician
  • Broomall, PA
  • NPI 1811949191
  NPD (past)
• Brian R. Boucher, MD

  • Family Medicine Physician
  • Coatesville, PA
  • NPI 1386614154
  NPD (past)
• James Andrew Egnor, PA C

  • Physician Assistant
  • Secane, PA
  • NPI 1770556524
  NPD (past)
• Patricia Guerra-Garcia, MD

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1770622458
  NPD (past)
• Gregory Mark Lehman, DO

  • Internal Medicine Physician
  • Springfield, PA
  • NPI 1598744112
  NPD (past)
• James M Minnella, MD

  • Internal Medicine Physician
  • Secane, PA
  • NPI 1346229176
  NPD (past)

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1598755340",
    "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": "831 PROVIDENCE RD",
            "city": "SECANE",
            "state": "PA",
            "postal_code": "190182921",
            "telephone_number": "610-934-1234",
            "fax_number": "610-934-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2008-03-20",
        "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": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1772599",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY HEALTHPLAN",
            "identifier": "30035743",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO PPO",
            "identifier": "1147948",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "2455345001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "37229",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007787930172",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Medical Associates at Providence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica M McTaggart, PHARMD
• Anthony M Mechell Jr., D.M.D
• Thomas E Meister, O.D.
• Merakey Delaware County
• Mercy Catholic Medical Center
• James M Minnella, MD
• Minute Care Transport LLC
• Mog International LLC (Mog Home Health Care Services)
• Molley Family Healthcare & Wellness Center LLC
• Ansu Siryon Molley

• Internal Medicine Physician in Secane, PA
• Providers in Secane, 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 20, 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.