Main Line Orthopaedics PC
Organization Active NPI Orthopaedic Surgery Physician · Bryn Mawr, PA
NPI 1750361978 · NPPES record last updated Sep 22, 2014
Key facts
- NPI
- 1750361978
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- MAIN LINE ORTHOPAEDICS PC
- Practice address
- 101 S Bryn Mawr Ave
Suite 200
Bryn Mawr, PA 19010-3120 - Phone
- (610) 527-9500
- Fax
- (610) 527-9529
- NPI assigned
- Jan 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Joseph V Vernace
- Title
- Owner
- Phone
- (610) 527-9500
Practitioners 4
-
Joseph V Vernace, MD
-
Timothy S Cavanaugh, PAC
-
Sara W Jackson, PA
-
Lisa S Kyriakatos, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040805000177 | PA | Part B Supplier - Clinic/Group Practice | 8820069529 |
Receives reassigned benefits from 3 practitioners Practice locations: Bryn Mawr, PA |
National Provider Directory
Locations
1230 American Blvd
West Chester, PA 19380
Phone (484) 473-6050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
101 S Bryn Mawr Ave
Suite 200
Bryn Mawr, PA 19010-3120
Mailing address
101 S Bryn Mawr Ave
Suite 200
Bryn Mawr, PA 19010-3120
Phone (610) 527-9500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CN2718 | Other | PA | TRAVELERS MEDICARE |
| 815911 | Other | HIGHMARK BS |
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All providers in Bryn Mawr, PA · Orthopaedic Surgery Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.