Organization Active NPI

Delaware County Rheumatology, PC

  • Rheumatology Physician
  • Media, PA
National Provider Identifier
1598848228
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
NOT APPLICABLE Issued in PA
Legal business name
DELAWARE COUNTY RHEUMATOLOGY, PC
Practice address
1088 W Baltimore Pike Ste 2105
Media, PA 19063-5136
Phone
(610) 565-5082
Fax
(610) 891-9955
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

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

Authorized official

Name
Dr. Ronald Bernhard Anderson, MDNPI 1194819938
Title
President
Phone
(610) 565-5082

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
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X NOT APPLICABLE PA Primary

Addresses

Primary practice location

1088 W Baltimore Pike Ste 2105
Media, PA 19063-5136

Mailing address

1088 W Baltimore Pike Ste 2105
Media, PA 19063-5136
Phone (610) 565-5082

Other identifiers 1

IdentifierTypeStateIssuer
100764770-0002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040813000192 PA Part B Supplier - Clinic/Group Practice 6709859382 Receives reassigned benefits from 1 practitioner
Practice locations: Media, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520812800000",
    "number": "1598848228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1088 W BALTIMORE PIKE STE 2105",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635136",
            "telephone_number": "610-565-5082",
            "fax_number": "610-891-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 W BALTIMORE PIKE STE 2105",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635136",
            "telephone_number": "610-565-5082",
            "fax_number": "610-891-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE COUNTY RHEUMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2018-03-12",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "BERNHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-565-5082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "NOT APPLICABLE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100764770-0002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; 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.