NPIMap

Organization Active NPI

Penn Presbyterian Medical Ctr Iop

  • Multi-Specialty Clinic/Center
  • Phila, PA
National Provider Identifier
1649310103
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PENN PRESBYTERIAN MEDICAL CTR IOP
Practice address
51 N 39TH St
Phila, PA 19104-2640
Phone
(215) 796-4640
Fax
(609) 770-7792
NPI assigned
Feb 7, 2007
Last updated
Mar 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Authorized official

Name
Mr. Thomas McCormick
Title
Assistant Vice President Finance
Phone
(215) 762-0888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

51 N 39TH St
Phila, PA 19104-2640

Mailing address

1500 Market St
Um600
Phila, PA 19102-2100
Phone (215) 796-4640

Other identifiers 1

IdentifierTypeStateIssuer
1007297070026MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

National Provider Directory

National Provider Directory
Tax ID family
Penn Presbyterian Medical Center Spu15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

1500 Market St
Ste UM600
Philadelphia, PA 19102

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1649310103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MARKET ST",
            "address_2": "UM600",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191022100",
            "telephone_number": "215-796-4640",
            "fax_number": "609-770-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-796-4640",
            "fax_number": "609-770-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN PRESBYTERIAN MEDICAL CTR IOP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "ASSISTANT VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "215-762-0888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007297070026",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.