Individual provider Active NPI

Elizabeth Herrup, MD

  • Pediatric Critical Care Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1740547785
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
MD464265 Issued in PA
Practice address
3401 Civic Center Blvd Ste 9329
Philadelphia, PA 19104-4319
Phone
(215) 590-1000
Fax
(215) 590-1415
NPI assigned
Apr 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME142086 FL
Pediatrics Physician 208000000X D79033 MD
Pediatrics Physician 208000000X MD464265 PA
Pediatric Critical Care Medicine Physician 2080P0203X MD464265 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd Ste 9329
Philadelphia, PA 19104-4319

Mailing address

3401 Civic Center Blvd Ste 9329
Philadelphia, PA 19104-4319
Phone (267) 425-9300

Other practice location 1

836 Prudential Dr
Jacksonville, FL 32207-8334
Phone (904) 202-8550

Other practice location 2

550 S Goddard Blvd
King Of Prussia, PA 19406-2922
Phone (610) 337-3232

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CHP@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190911000533 PA Practitioner - Pediatric Medicine 5698081768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Massachusetts Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Anesthesiology Associates LTDGroup PAC ID 5799688529, 60 clinicians

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-1858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D79033MDMDPediatrics Physician
MD464265PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Anesthesiology Associates, LTD Current Accepting new patients
Children'S Anesthesiology Associates, LTD Pediatrics CurrentSince Sep 19, 2022 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 15, 2019 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 15, 2019 Accepting new patients
Children'S Anesthesiology Associates, LTD Pediatrics CurrentSince Sep 19, 2022 Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients
Baptist Specialty Physicians Inc PastSince Apr 24, 2022 Accepting new patients

Locations

550 S Goddard Blvd
King of Prussia, PA 19406
Phone (610) 337-3232

3401 Civic Center Blvd
Ste 9329
Philadelphia, PA 19104
Phone (267) 425-9300

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

3550 Ter St
Pittsburgh, PA 15261
Phone (412) 647-8977

4401 Penn Ave
Fl 4
Pittsburgh, PA 15224
Phone (412) 692-5090

4401 Penn Ave
Pittsburgh, PA 15224
Phone (412) 692-5030

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1740547785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD STE 9329",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "267-425-9300",
            "fax_number": "267-425-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD STE 9329",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1000",
            "fax_number": "215-590-1415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "836 Prudential Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078334",
            "country_code": "US",
            "telephone_number": "904-202-8550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 S Goddard Blvd",
            "address_purpose": "LOCATION",
            "city": "King Of Prussia",
            "state": "PA",
            "postal_code": "194062922",
            "country_code": "US",
            "telephone_number": "610-337-3232",
            "fax_number": "610-337-0325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRUP",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME142086",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D79033",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD464265",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "PA",
            "license": "MD464265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CHP@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.