Main Line Internal Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD046844L Issued in PA

Legal business name

MAIN LINE INTERNAL MEDICINE LLC

Practice address

11 Industrial Blvd
Suite 101
Paoli, PA 19301-1632

Phone

(610) 695-9878

NPI assigned

Dec 4, 2006

Last updated

Jan 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elana Kripke, MDNPI 1184633927

Title

Physician

Phone

(610) 695-9878

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elana N. Kripke, M.D.

  • Internal Medicine Physician
  • Paoli, PA
  • NPI 1184633927
  Medicare reassignment NPD Authorized official
• George H Steele, MD

  • Internal Medicine Physician
  • Paoli, PA
  • NPI 1912946419
  Medicare reassignment NPD
• Lilia Sugarman, M.D.

  • Internal Medicine Physician
  • Paoli, PA
  • NPI 1235572066
  NPD

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1780742841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 INDUSTRIAL BLVD",
            "address_2": "SUITE 101",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011632",
            "telephone_number": "610-695-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 INDUSTRIAL BLVD",
            "address_2": "SUITE 101",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011632",
            "telephone_number": "610-695-9878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "KRIPKE",
        "authorized_official_first_name": "ELANA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "610-695-9878",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD046844L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001280938004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Main Line Emergency Med Associates LLC
• Main Line Gastroenterology Associates, PC
• Main Line Hand Center LLC
• Main Line Hospitals, Inc.
• Main Line Hospitals, Inc. (Paoli Hospital)
• Main Line Neuropsychology, PLLC
• Main Line Treatment, LLC
• Mainline Center for Oral & Facial Surgery LTD
• Daniel Malloy-Good
• Beth Mallozzi-Roberts, DO

• Internal Medicine Physician in Paoli, PA
• Providers in Paoli, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.