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Organization Active NPI

Univ of Penn Community Radiology

  • Diagnostic Radiology Physician
  • Wayne, PA
National Provider Identifier
1740293232
Registry record updated Jul 15, 2011
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Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
UNIV OF PENN COMMUNITY RADIOLOGY
Practice address
999 Old Eagle School Rd
Wayne, PA 19087-1707
Phone
(215) 702-3100
Fax
(215) 702-3105
NPI assigned
Aug 14, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Elizabeth Johnston
Title
Executive Director
Phone
(215) 662-7583

Practitioners 174

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

View all 174

National Provider Directory

National Provider Directory

Locations

491 Allendale Rd
Ste 104
Kng of Prussa, PA 19406
Phone (215) 860-3360

404 Middletown Blvd
Ste 300
Langhorne, PA 19047
Phone (215) 702-3100

250 King of Prussia Rd
Ste 3
Radnor, PA 19087
Phone (610) 902-1800

999 Old Eagle School Rd
Ste 118
Wayne, PA 19087
Phone (610) 341-9812

999 Old Eagle School Rd
Wayne, PA 19087
Phone (561) 335-5867

Specialties & licenses 5

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207U00000X
Neuroradiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0700X
Pediatric Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085P0229X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X

Addresses

NPPES NPI Registry

Primary practice location

999 Old Eagle School Rd
Wayne, PA 19087-1707

Mailing address

3624 Market St
Suite 560W
Philadelphia, PA 19104-2614
Phone (215) 662-3958

Other identifiers 9

NPPES NPI Registry
IdentifierTypeStateIssuer
548327OtherPACIGNA
705030OtherPABLUE SHIELD
8390801MedicaidNJ
0016394230MedicaidPA
33158OtherPAMERCY
548327OtherPAAETNA
31072OtherPAHEALTHPARTNERS
0002Y22562OtherPAHEALTHNET
0794791000OtherPAKEYSTONE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 15, 2011.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310688000000",
    "number": "1740293232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 MARKET ST",
            "address_2": "SUITE 560W",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042614",
            "telephone_number": "215-662-3958",
            "fax_number": "215-615-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 OLD EAGLE SCHOOL RD",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190871707",
            "telephone_number": "215-702-3100",
            "fax_number": "215-702-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIV OF PENN COMMUNITY RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2011-07-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-662-7583"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Pediatric Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "548327",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "705030",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8390801",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016394230",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "33158",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "548327",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "31072",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0002Y22562",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0794791000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.