Trustees of the University of Pennsylvania

Primary specialty

Psychiatric Hospital UnitTaxonomy code 273R00000X

Legal business name

TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA

Practice address

3400 Spruce St
Philadelphia, PA 19104-4206

Phone

(215) 796-4640

Fax

(609) 770-7792

NPI assigned

Jan 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Thomas McCormick Jr.

Title

Avp of Finance

Phone

(215) 762-0888

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Hospital of the University of Pennsylvania Doing business as

Electronic endpoints 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Trustees of the University of Pennsylvania

  • Community/Retail Pharmacy
  • Radnor, PA
  • NPI 1922029982

  Member Of

  NPD member

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680825600000",
    "number": "1679544803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MARKET ST",
            "address_2": "UM600",
            "city": "PHILADELPHIA",
            "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": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-796-4640",
            "fax_number": "609-770-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "AVP OF FINANCE",
        "authorized_official_telephone_number": "215-762-0888",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0001043000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4193105",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001258770126",
            "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": [
        {
            "organization_name": "Hospital of the University of Pennsylvania",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hospital of the University of Pennsylvania",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trustees of the University of Pennsylvania
• Trustees of the University of Pennsylvania
• Trustees of the University of Pennsylvania
• Trustees of the University of Pennsylvania
• Trustees of the University of Pennsylvania
• Trustees of the University of Pennsylvania
• Trustees of the University of Pennsylvania
• Trustees of the University of Pennsylvania
• Trustees of the University of Pennsylvania
• Trustees of the University of Pennsylvania

• All providers in Philadelphia, PA
• Psychiatric Hospital Unit in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.