Boothwyn Medical Associates P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD030635E Issued in PA

Legal business name

BOOTHWYN MEDICAL ASSOCIATES P.C.

Practice address

1440 Conchester Hwy
Suite 5a
Boothwyn, PA 19061-2124

Phone

(610) 459-3722

Fax

(610) 459-4730

NPI assigned

Jun 7, 2006

Last updated

Aug 12, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rodney M. Elkin, M.D.

Title

Physician/President

Phone

(610) 459-3722

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Manuel T. Lim, MD

  • Adult Medicine Physician
  • Boothwyn, PA
  • NPI 1679513576
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313107200000",
    "number": "1699715086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 CONCHESTER HWY",
            "address_2": "SUITE 5A",
            "city": "BOOTHWYN",
            "state": "PA",
            "postal_code": "190612124",
            "telephone_number": "610-459-3722",
            "fax_number": "610-459-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 CONCHESTER HWY",
            "address_2": "SUITE 5A",
            "city": "BOOTHWYN",
            "state": "PA",
            "postal_code": "190612124",
            "telephone_number": "610-459-3722",
            "fax_number": "610-459-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOTHWYN MEDICAL ASSOCIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2011-08-12",
        "status": "A",
        "authorized_official_last_name": "ELKIN",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "610-459-3722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "PA",
            "license": "MD038926L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD030635E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012788500001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Acme Markets Inc (Acme Pharmacy #2693)
• Sarah Margaret Clark, P.T.
• Classic Physical Therapy and Rehab Center Inc
• John Cole Jr., CPHT
• Consolidated Vision Group (America's Best Contacts & Eyeglasses)
• Stephanie Lynne Dangelantonio, PHARM.D

• Internal Medicine Physician in Boothwyn, PA
• Providers in Boothwyn, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.