NPIMap

Organization Active NPI

St Mary Medical Center

Doing business as St Mary Adult Health Center

  • Internal Medicine Physician
  • Bensalem, PA
National Provider Identifier
1710470323
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ST MARY MEDICAL CENTER
Doing business as
St Mary Adult Health Center
Practice address
2546B Knights Rd
Bensalem, PA 19020
Phone
(215) 633-8397
Fax
(215) 642-3588
NPI assigned
Jun 8, 2018
Organization subpart
Yes
Parent organization
ST MARY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Authorized official

Name
Sharon Profera
Title
Director of Finance
Phone
(215) 710-2013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2546B Knights Rd
Bensalem, PA 19020

Mailing address

41 University Dr Ste 300
Newtown, PA 18940-1873
Phone (215) 710-5522

Other names 1

  • St Mary Adult Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190404000590 PA Part B Supplier - Clinic/Group Practice 4688588064 Receives reassigned benefits from 37 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bensalem, PA

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Part of
St Mary Medical Center

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1710470323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 UNIVERSITY DR STE 300",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401873",
            "telephone_number": "215-710-5522",
            "fax_number": "215-710-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2546B KNIGHTS RD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "19020",
            "telephone_number": "215-633-8397",
            "fax_number": "215-642-3588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST MARY MEDICAL CENTER",
        "enumeration_date": "2018-06-08",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "PROFERA",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "215-710-2013"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Mary Adult Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bensalem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.