Individual provider Active NPI

Sean Pepley

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1750847331
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW020174 Issued in PA
Practice address
1900 N 9TH St Ste 104
Philadelphia, PA 19122-2028
Phone
(215) 765-6690
NPI assigned
Feb 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW020174 PA Primary

Addresses

Primary practice location

1900 N 9TH St Ste 104
Philadelphia, PA 19122-2028

Mailing address

1500 Market St.
LM 500 West Tower
Philadelphia, PA 19102
Phone (215) 731-2406

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190322000057 PA Practitioner - Clinical Social Worker 0345580775 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
GKSW Crystal Group AssociatesGroup PAC ID 7810898152, 14 clinicians

Practice addresses (Care Compare)

8200 Flourtown Ave
Wyndmoor, PA 19038-7969
Phone (215) 233-3994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW020174PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Mar 19, 2020 Accepting new patients
Public Health Management Corporation CurrentSince Mar 1, 2019 Accepting new patients
University of Penn-Medical Group CurrentSince Mar 19, 2020 Accepting new patients
Public Health Management Corporation Current Accepting new patients
Public Health Mangement Corporation CurrentSince Mar 1, 2019 Accepting new patients
GKSW Crystal Group Associates Clinical CurrentSince Sep 1, 2021 Accepting new patients

Locations

125 S 9th St
Philadelphia, PA 19107
Phone (215) 592-4500

5675 N Front St
Philadelphia, PA 19120
Phone (215) 224-0440

3535 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2816

1500 Market St
Ste LM500
Philadelphia, PA 19102
Phone (215) 731-6150

1900 N 9th St
Ste 104
Philadelphia, PA 19122
Phone (215) 735-6690

8200 Flourtown Ave
Ste 8
Wyndmoor, PA 19038
Phone (215) 233-3994

Organizations & group practices 6

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": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1750847331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MARKET ST.",
            "address_2": "LM 500 WEST TOWER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-731-2406",
            "fax_number": "267-765-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N 9TH ST STE 104",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191222028",
            "telephone_number": "215-765-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPLEY",
        "first_name": "SEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.