Kensington Hospital- Erie Medical Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

111101 Issued in PA

Legal business name

KENSINGTON HOSPITAL- ERIE MEDICAL CENTER

Practice address

136 Diamond St
Philadelphia, PA 19122-1721

Phone

(215) 426-8100

Fax

(215) 965-2344

NPI assigned

Jan 9, 2007

Organization subpart

Yes

Parent organization

KENSINGTON HOSPITALAs reported in NPPES

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

Authorized official

Name

Ms. Eileen Hause, M.B.A.

Title

Chief Executive Officer

Phone

(215) 426-8100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

Hospital certification: CCN 390025

Legal name

KENSINGTON HOSPITAL

Certification status

Active

Provider type (POS)

Hospital – Short-term

Participating since

Jul 1, 1966

Last certification

Nov 9, 2017

Beds

31

Ownership / control type

Other

Organization structure

CorporationNon-profit

Enrollment address

136 Diamond St
Philadelphia, PA 19122-1721
Main/Primary Hospital Location

Hospital subgroups

General

Other NPIs on the same Medicare enrollment 3

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

• Kensington Hospital

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1114953619

  O20081010000301

  Same enrollment
• Kensington Hospital- Cambria Clinic

  • Primary Care Clinic/Center
  • Philadelphia, PA
  • NPI 1720136112

  O20040420000239, O20081010000301

  Same enrollment
• Kensington Hospital- Clinic

  • Primary Care Clinic/Center
  • Philadelphia, PA
  • NPI 1902955586

  O20040420000239

  Same enrollment

Listed as

Kensington HospitalCCN 390025

Type

Acute Care Hospitals

Ownership

Voluntary non-profit - Other

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

No

Part of

Anesthesiology Kensingt

Locations

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Kensington Hospital

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1114953619

  Operational/Managerial Control

  CMS ownership
• Kensington Hospital

  • Methadone Clinic
  • Philadelphia, PA
  • NPI 1851745566

  Operational/Managerial Control

  CMS ownership
• Kensington Hospital- Clinic

  • Primary Care Clinic/Center
  • Philadelphia, PA
  • NPI 1902955586

  Operational/Managerial Control

  CMS ownership
• Monika Vansant, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1962441683

  Contracted Managing Employee

  CMS ownership

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Kensington Hospital

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1114953619
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohammad Azher Sayeed, MD

  • Pulmonary Disease Physician
  • Phila, PA
  • NPI 1700888500
  NPD
• Emily M Levitt-Gopie, CRNP

  • Family Nurse Practitioner
  • Honolulu, HI
  • NPI 1992006217
  NPD
• Nand Ram, MD

  • Internal Medicine Physician
  • Moorestown, NJ
  • NPI 1992799522
  NPD

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Mohammad Azher Sayeed, MD

  • Pulmonary Disease Physician
  • Phila, PA
  • NPI 1700888500

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1710036041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 W ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404535",
            "telephone_number": "215-228-2844",
            "fax_number": "215-228-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 DIAMOND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191221721",
            "telephone_number": "215-426-8100",
            "fax_number": "215-965-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENSINGTON HOSPITAL- ERIE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENSINGTON HOSPITAL",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "HAUSE",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "215-426-8100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.B.A."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PA",
            "license": "111101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kensington Hospital Outpatient Treatment Program
• Kensington Hospital Substance Abuse Services
• Kensington Hospital- Cambria Clinic
• Kensington Hospital- Clinic
• Kensington Hospital- Congreso Clinic
• Kensington Hospital- Family Planning Clinic
• Kensington Hospital- Intensive Outpatient Program
• Kensington Hospital-Case Management Services
• Kensington Paradise Dental PC
• Jacqueline Marie Kent-Marvick, PHD, RN

• Primary Care Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Primary Care Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.