Belmont Behavioral Hospital, LLC
Organization Active NPI Psychiatric Hospital · Philadelphia, PA
NPI 1629468137 · NPPES record last updated Jan 20, 2026
Key facts
- NPI
- 1629468137
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital 283Q00000X
- Legal business name
- BELMONT BEHAVIORAL HOSPITAL, LLC
- Practice address
- 4200 Monument Rd
Philadelphia, PA 19131-1625 - Phone
- (215) 456-6611
- NPI assigned
- Feb 4, 2015
- Organization subpart
- No
Authorized official
- Name
- Mr. Brian P Farley
- Title
- VP & Secretary
- Phone
- (615) 861-6000
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 3
Facilities with the same owner 59
Practitioners 53
-
Emeka Benson Boka, M.D.
-
Rohan Gopalani, MD
-
Tuhin Gupta, MD
-
Justin Michael Lazaroff, D.O.
-
David Mark Leach, M.D.
-
Phillip Michael Orlando, D.O.
-
Tracey Sewter-Cohen, PMHNP-BC
-
Mohammed Nazrul Islam, M.D.
-
Tarita Nicole Collins, D.O.
-
Scott Abrams, PHD
-
MD Ashik Ansar, M.D., PH.D
-
Brad Bernstein, PSY.D, LPC
-
Philip Brooks, LMFT
-
David Goodwin, PHD
-
David Jonathan Halpern, M.D.
-
Adam Hofbauer, LSW
-
Erica Penn Hoffman, LCSW-C
-
Ai Ikunaga, PSY.D.
-
Richard L Jaffe, MD
-
Jonathan Kersun, M.D.
-
Chong Hwan Kim, MD
Medicare Care Compare: Hospital
- Listed as
- Belmont Behavioral Hospital
- Type
- Psychiatric
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- No
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D1088435 | Belmont Behavioral Hospital, LLC | Certificate of waiver | Aug 25, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA
Hospital certification: CCN 394023
- Legal name
- BELMONT BEHAVIORAL HOSPITAL LLC
- Doing business as
- BELMONT BEHAVIORAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Psychiatric
- Participating since
- Jul 1, 1966
- Last certification
- Mar 21, 2014
- Beds
- 147
- Ownership / control type
- Private (not for profit)
- Most recent change of ownership
- Aug 13, 2015 (4 total)
- Organization structure
- LLC · Proprietary
- Incorporated
- Apr 24, 2014 in DE
- Enrollment address
- 4200 Monument Rd
Philadelphia, PA 19131-1625 - Hospital subgroups
- Psychiatric
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Deborah S Kraemer |
W-2 Managing Employee |
Jun 11, 2012 | |
| Todd S Young |
Corporate Officer |
Oct 27, 2025 | |
| Acadia Healthcare Company Inc |
5% Or Greater Direct Ownership Interest | Jul 1, 2015 | 100% |
| Stacie L Harty |
W-2 Managing Employee |
Jun 18, 2018 | |
| Jacqueline M Basile |
W-2 Managing Employee |
Jan 1, 2025 | |
| Brian Philip Farley |
Corporate Officer |
Jul 26, 2023 | |
| Timothy a Sides |
W-2 Managing Employee |
Jun 5, 2023 | |
| Debra K Osteen |
Corporate Officer |
Jan 20, 2026 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150813009807 | PA | Part a Provider - Hospital | 1153636691 |
2 other NPIs on this enrollment Practice locations: Philadelphia, PA |
| O20151208000473 | PA | Part B Supplier - Clinic/Group Practice | 1153636691 |
Receives reassigned benefits from 51 practitioners 2 other NPIs on this enrollment Practice locations: Philadelphia, PA |
National Provider Directory
- Tax ID family
- Belmont Behavioral Hospital
Locations
4200 Monument Rd
Philadelphia, PA 19131
Phone (215) 456-6611
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | Yes |
Addresses
Primary practice location
4200 Monument Rd
Philadelphia, PA 19131-1625
Mailing address
4020 Aspen Grove Dr Ste 900
Franklin, TN 37067-3134
Phone (615) 861-6000
Other names
- Belmont Behavioral Hospital
Other providers in Philadelphia, PA
- Leo Belman
- Belmont Academy Charter School
- Belmont Academy Charter School
- Belmont Behavioral Hospital, LLC
- Belmont Behavioral Hospital, LLC
- Belmont Charter School
- Belmont Charter School
- Belmont Court Dialysis Center Inc
- Belmont Court Dialysis Center Inc
- Joseph Tyler Belmont
All providers in Philadelphia, PA · Psychiatric Hospital in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.