Kathryn Marissa Pallegedara, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD470136 Issued in PA

Practice address

5003 Umbria St
Philadelphia, PA 19128-4369

Phone

(215) 483-3444

NPI assigned

Jun 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kathryn Marissa Paolucci Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Children's Hospital of Philadelphia

  dba CHOP Primary Care Doylestown

  • Pediatrics Physician
  • Doylestown, PA
  • NPI 1427148808
  NPD (past)

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

{
    "created_epoch": "1496448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1760910780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BOULEVARD",
            "address_2": "THE CHILDREN'S HOSPITAL OF PHILADELPHIA, 9NW ROOM 55",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044399",
            "telephone_number": "215-590-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5003 UMBRIA ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191284369",
            "telephone_number": "215-483-3444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Civic Center Blvd Rm 55",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "215-590-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALLEGEDARA",
        "first_name": "KATHRYN",
        "middle_name": "MARISSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-03",
        "last_updated": "2022-07-21",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT212738",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD470136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "PAOLUCCI",
            "middle_name": "MARISSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Ann Palko
• Andrew A. Palladino, MD
• Michael John Palladino, PHARM.D.
• Blair E Pallas, LCSW
• Pallavi Batra DMD PC
• Bonny C Palma, NURSE
• Andrew D Palmatier, M.S.
• Joshua Mark Palmbach, DO
• Alexa Palmer
• Caroline Palmer

• Pediatrics Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.