Organization Active NPI

Atlantic Health Care PLLC

  • Interventional Pain Medicine Physician
  • Willow Grove, PA
National Provider Identifier
1720425929
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
MD422681 Issued in PA
Legal business name
ATLANTIC HEALTH CARE PLLC
Practice address
359 York Rd
Store Front
Willow Grove, PA 19090-2621
Phone
(215) 366-7141
Fax
(215) 933-3120
NPI assigned
May 29, 2013
Last updated
May 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Authorized official

Name
Ms. Amanda L Ricca
Title
Manager
Phone
(215) 651-8180

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD422681 PA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD442471 PA
Interventional Pain Medicine Physician 208VP0014X MD422681 PA Primary

Addresses

Primary practice location

359 York Rd
Store Front
Willow Grove, PA 19090-2621

Mailing address

359 York Rd
Store Front
Willow Grove, PA 19090-2621
Phone (215) 366-7141

Other identifiers 1

IdentifierTypeStateIssuer
APPLIEDOtherPAIBC

National Provider Directory

National Provider Directory

Locations

359 N York Rd
Frnt
Willow Grove, PA 19090
Phone (215) 366-7141

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1720425929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 YORK RD",
            "address_2": "STORE FRONT",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190902621",
            "telephone_number": "215-366-7141",
            "fax_number": "215-933-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 YORK RD",
            "address_2": "STORE FRONT",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190902621",
            "telephone_number": "215-366-7141",
            "fax_number": "215-933-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC HEALTH CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "RICCA",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "215-651-8180",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD422681",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD442471",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "PA",
            "license": "MD422681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "APPLIED",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Grove, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.