Individual provider Active NPI

Rose Marie Covalesky, PA-C

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1609969625
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA002765L Issued in PA
Practice address
1703 S Broad St
Ste 300
Philadelphia, PA 19148-1536
Phone
(215) 463-5353
Fax
(215) 463-8085
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA002765L PA Primary

Addresses

Primary practice location

1703 S Broad St
Ste 300
Philadelphia, PA 19148-1536

Mailing address

207 N Broad St
3Rd FLR Cardiology Consultants of Phila
Phila, PA 19107
Phone (215) 462-7100

Other identifiers 1

IdentifierTypeStateIssuer
MA002765LOtherPALICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA002765LPAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Penn Medicine CCP Past Accepting new patients

Organizations & group practices 1

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1609969625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BROAD ST",
            "address_2": "3RD FLR CARDIOLOGY CONSULTANTS OF PHILA",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-462-7100",
            "fax_number": "215-463-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S BROAD ST",
            "address_2": "STE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191481536",
            "telephone_number": "215-463-5353",
            "fax_number": "215-463-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVALESKY",
        "first_name": "ROSE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA002765L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "MA002765L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.