Individual provider Active NPI

Perry Avery Cain, PA-C

  • Physician Assistant
  • Phila, PA
National Provider Identifier
1649257528
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA002642L Issued in PA
Practice address
3401 N. Broad Street
Phila, PA 19140
Phone
(215) 707-5030
Fax
(215) 707-3494
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA002642L PA Primary

Addresses

Primary practice location

3401 N. Broad Street
Phila, PA 19140

Mailing address

2450 W. Hunting Park Avenue
Phila, PA 19129
Phone (215) 707-5030

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140109000390 PA Practitioner - Physician Assistant 4082842448 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA002642LPAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physician Inc. CurrentSince Jun 1, 2015 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 11, 2019 Accepting new patients
HR Physician Services CurrentSince Aug 22, 2016 Accepting new patients
HR Physician Services CurrentSince Aug 22, 2016 Accepting new patients
Temple Physicians Inc CurrentSince Jun 1, 2015 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Mar 11, 2019 Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

1648 Huntingdon Pike
Ofc 1ST
Meadowbrook, PA 19046

1648 Huntingdon Pike
Meadowbrook, PA 19046
Phone (215) 938-3413

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

Organizations & group practices 9

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1649257528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W. HUNTING PARK AVENUE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19129",
            "telephone_number": "215-707-5030",
            "fax_number": "215-707-3494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N. BROAD STREET",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "215-707-5030",
            "fax_number": "215-707-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "PERRY",
        "middle_name": "AVERY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002642L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

Verify at the official NPI Registry.