Clinical Care Associates of the University of Pennsylvania Health Syst
Organization Active NPI Hospitalist Physician · Bala Cynwyd, PA
NPI 1790737468 · NPPES record last updated Aug 9, 2023
Key facts
- NPI
- 1790737468
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hospitalist Physician 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
- Organization subpart
- No
Authorized official
- Name
- Chante L Jackson
- Title
- Enrollment Lead
- Phone
- (215) 662-6187
Other NPIs on the same Medicare enrollment 6
Practitioners 673
-
Monica Marie Aber, CRNP
-
Leslie Adeoye, CRNP
-
Andrew Martin Agostini, M.D.
-
Ann J Aharon, CRNP
-
Maria Alesi-Hannold, CRNP
-
Darcy E Alimenti, CRNP
-
Renee T Anderson, DO
-
Alan D Askenase, MD
-
Elizabeth Ann Attig, CRNP
-
Susan J Back, M.D.
-
Charles J Bae, MD
-
Kurtavious V Ball Sr., M.M.C, PA-C
-
Richard D Bellah, MD
-
Siddharth Bhattacharyya, M,D,
-
Lisa B Black, MD
-
Steven Eric Blasek, CRNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031113000301 | PA | Part B Supplier - Clinic/Group Practice | 4688588866 |
Receives reassigned benefits from 1,081 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations (25 of 44)
3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113
200 Campbell Dr
Ste 107
Willingboro, NJ 08046
Phone (609) 614-3997
1001 Chesterbrook Blvd
Ste 200
Berwyn, PA 19312
Phone (610) 576-7500
1001 Chesterbrook Blvd
Fl 2E
Berwyn, PA 19312
1001 Chesterbrook Blvd
#3
Berwyn, PA 19312
1001 Chesterbrook Blvd
Fl 3E
Berwyn, PA 19312
711 W Lancaster Ave
Bryn Mawr, PA 19010
Phone (610) 520-4600
700 Horizon Dr
Ste 101
Chalfont, PA 18914
Phone (215) 453-5610
728 W Lincoln Hwy
Fl 2
Exton, PA 19341
Phone (610) 423-4556
906 Bethlehem Pike
Fl 2
Glenside, PA 19038
420 W Township Line Rd
Havertown, PA 19083
Phone (215) 624-7201
888 1St Ave
King of Prussia, PA 19406
605 W State St
#2
Media, PA 19063
Phone (610) 565-8600
700 Spruce St
Ste 301
Phila, PA 19106
800 Spruce St
#4
Philadelphia, PA 19107
4631 Baltimore Ave
Philadelphia, PA 19143
Phone (215) 726-8299
3737 Market St
Fl 8
Philadelphia, PA 19104
Phone (215) 662-4333
1930 S Broad St
Unit 14
Philadelphia, PA 19145
Phone (215) 685-1803
235 S 8th St
Philadelphia, PA 19106
Phone (215) 543-2770
170 S Independence Mall W
Ste 230E
Philadelphia, PA 19106
800 Spruce St
#1W
Philadelphia, PA 19107
Phone (215) 829-7817
800 Spruce St
Ste 3E
Philadelphia, PA 19107
2240 S 3rd St
Fl 2
Philadelphia, PA 19148
Phone (215) 755-8575
33 E Chestnut Hill Ave
Ste 201
Philadelphia, PA 19118
Phone (215) 247-0900
800 Spruce St
Fl 1
Philadelphia, PA 19107
Phone (215) 829-5873
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician |
207PE0004X | |||
| Sports Medicine (Emergency Medicine) Physician |
207PS0010X | |||
| Internal Medicine Physician |
207R00000X | |||
| Cardiovascular Disease Physician |
207RC0000X | PA | ||
| Endocrinology, Diabetes & Metabolism Physician |
207RE0101X | |||
| Hospice and Palliative Medicine (Internal Medicine) Physician |
207RH0002X | |||
| Infectious Disease Physician |
207RI0200X | |||
| Rheumatology Physician |
207RR0500X | |||
| Sleep Medicine (Internal Medicine) Physician |
207RS0012X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Neurology Physician |
2084N0400X | |||
| Surgery Physician |
208600000X | PA | ||
| Hospitalist Physician |
208M00000X | Yes |
Addresses
Primary practice location
150 Monument Rd FL 4
Bala Cynwyd, PA 19004-1702
Mailing address
150 Monument Rd FL 4
Bala Cynwyd, PA 19004-1702
Phone (610) 239-2871
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1343994 | Other | PA | BLUE SHIELD |
| 428207 | Other | PA | BLUE SHIELD |
| 100730664 | Medicaid | PA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
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All providers in Bala Cynwyd, PA · Hospitalist 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 Aug 9, 2023. 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.