Pennmed Care PA PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

PENNMED CARE PA PC

Practice address

841 E Hunting Park Ave Ste 110
Philadelphia, PA 19124-4813

Phone

(215) 709-3800

Fax

(215) 476-1427

NPI assigned

Jan 28, 2025

Organization subpart

No

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

Authorized official

Name

John Manzella, DO

Title

Administrator

Phone

(215) 709-3800

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 3

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

• Haytham Albizem, MD

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1467442285
  Medicare reassignment NPD
• Joseph Mojoko Koroma, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
  • NPI 1689351546
  Medicare reassignment NPD
• Brandon Pisani, PA-C

  • Medical Physician Assistant
  • Clementon, NJ
  • NPI 1992446538

  PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1738022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1750194569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9369",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191399369",
            "telephone_number": "215-709-3800",
            "fax_number": "215-476-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 E HUNTING PARK AVE STE 110",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191244813",
            "telephone_number": "215-709-3800",
            "fax_number": "215-476-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNMED CARE PA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "MANZELLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "215-709-3800",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penncare-J. Edwin Wood Clinic
• Mara Emily Penne
• Infinity Pennington
• Jessica Elizabeth Pennington, MD
• Kiersten Marie Pennington, LCSW
• Danielle Maria Pennock, PHARMD
• Pennsbury Inpatient Services, LLC
• Pennslyvania Oncology Hematology Associates
• Pennsport Mall Pharmacy LLC
• Pennsport Physical Therapy Inc

• Cardiovascular Disease Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Cardiovascular Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.