NPIMap

Organization Active NPI

Pmsi Division of Cardiology

  • Cardiovascular Disease Physician
  • Pottstown, PA
National Provider Identifier
1710001136
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD044234E
Legal business name
PMSI DIVISION OF CARDIOLOGY
Practice address
1591 Medical Drive
Pottstown, PA 19464
Phone
(610) 326-8005
Fax
(610) 718-0788
NPI assigned
Mar 19, 2007
Organization subpart
Yes
Parent organization
POTTSTOWN MEDICAL SPECIALIST, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Authorized official

Name
Shana M Enochs
Title
Credentialing Specialist
Phone
(610) 327-4200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X MD044234E Primary
Interventional Cardiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RI0011X MD062953L

Addresses

Primary practice location

1591 Medical Drive
Pottstown, PA 19464

Mailing address

1591 Medical Drive
Pottstown, PA 19464
Phone (610) 326-8005

Other identifiers 2

IdentifierTypeStateIssuer
919371OtherPABLUE SHIELD ASSIGN. ACCT
0859976000OtherKEYSTONE HMO

Other names 1

  • Pottstown Medical Specialists Cardiology Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040426000589 PA Part B Supplier - Clinic/Group Practice 8224024096 Receives reassigned benefits from 51 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boyertown, PA; Collegeville, PA; Pottstown, PA; Royersford, PA; Stowe, PA

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory
Part of
Stowe Medical Group

Locations

1591 Medical Dr
Pottstown, PA 19464
Phone (610) 326-8005

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1710001136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1591 MEDICAL DRIVE",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "19464",
            "telephone_number": "610-326-8005",
            "fax_number": "610-718-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 MEDICAL DRIVE",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "19464",
            "telephone_number": "610-326-8005",
            "fax_number": "610-718-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PMSI DIVISION OF CARDIOLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POTTSTOWN MEDICAL SPECIALIST, INC.",
        "enumeration_date": "2007-03-19",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "ENOCHS",
        "authorized_official_first_name": "SHANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "610-327-4200"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": "MD044234E",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": "MD062953L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ASSIGN. ACCT",
            "identifier": "919371",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HMO",
            "identifier": "0859976000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pottstown Medical Specialists Cardiology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pottstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.