Clinical Care Associates of the University of Pennsylvania Health Syst

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

Legal business name

CLINICAL CARE ASSOCIATES OF THE UNIVERSITY OF PENNSYLVANIA HEALTH SYST

Practice address

150 Monument Rd FL 4
Bala Cynwyd, PA 19004-1702

Phone

(610) 239-2871

Fax

(610) 239-2885

NPI assigned

May 17, 2006

Last updated

Aug 9, 2023By 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

Chante L Jackson

Title

Enrollment Lead

Phone

(215) 662-6187

Specialties & licenses 13

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Clinical Care Associates of the University of

  • Anesthesiology Physician
  • West Chester, PA
  • NPI 1518541887

  O20031113000301

  Same enrollment
• Clinical Care Associates of the University of Pennsylvania Health

  • Hepatology Physician
  • West Chester, PA
  • NPI 1396416251

  O20031113000301

  Same enrollment
• Clinical Care Associates of the University of Pennsylvania Health

  • Psychologist
  • West Chester, PA
  • NPI 1649940107

  O20031113000301

  Same enrollment
• Clinical Care Associates of the University of Pennsylvania Health

  • Internal Medicine Physician
  • Radnor, PA
  • NPI 1972682995

  O20031113000301

  Same enrollment
• Clinical Care Associates of the University of Pennsylvania Health Syst

  • Urgent Care Clinic/Center
  • Philadelphia, PA
  • NPI 1508380452

  O20031113000301

  Same enrollment
• Clinical Care Associates of the University of Pennsylvania Health Syst

  • Orthopaedic Foot and Ankle Surgery Physician
  • Philadelphia, PA
  • NPI 1942319777

  O20031113000301

  Same enrollment

Locations (25 of 56)

Practitioners 676

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.

• Michael Elias Abboud, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
  • NPI 1962820852
  NPD
• Monica Marie Aber, CRNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
  • NPI 1922876820
  NPD
• Amarachi Daphne Acholonu, M.D

  • Internal Medicine Physician
  • West Chester, PA
  • NPI 1770946311
  NPD
• Leslie Adeoye, CRNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
  • NPI 1619771128

  Multi-Specialty

  NPD
• Andrew Martin Agostini, M.D.

  • Neurology Physician
  • Philadelphia, PA
  • NPI 1144759440
  NPD
• Ann J Aharon, CRNP

  • Women's Health Nurse Practitioner
  • Philadelphia, PA
  • NPI 1548599517
  NPD
• Olufolakemi Adetutu Akinkunmi, MD

  • Obstetrics & Gynecology Physician
  • Philadelphia, PA
  • NPI 1184936296
  NPD
• Maria Alesi-Hannold, CRNP

  • Nurse Practitioner
  • Wayne, PA
  • NPI 1396807731
  NPD
• Darcy E Alimenti, CRNP

  • Gerontology Nurse Practitioner
  • Philadelphia, PA
  • NPI 1356815120
  NPD
• Marietta S Ambrose, MD

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1700085214
  NPD
• Renee T Anderson, DO

  • Obstetrics & Gynecology Physician
  • Philadelphia, PA
  • NPI 1578628517
  NPD
• Alan D Askenase, MD

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1033141320
  NPD

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1790737468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD FL 4",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041702",
            "telephone_number": "610-239-2871",
            "fax_number": "610-239-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD FL 4",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041702",
            "telephone_number": "610-239-2871",
            "fax_number": "610-239-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL CARE ASSOCIATES OF THE UNIVERSITY OF PENNSYLVANIA HEALTH SYST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CHANTE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ENROLLMENT LEAD",
        "authorized_official_telephone_number": "215-662-6187"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "428207",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1343994",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100730664",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Hospitalist Physician in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Hospitalist Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.