NPIMap

Organization Active NPI

Phoenixville Clinic Company LLC

Doing business as Phoenixville Surgical Associates

  • Vascular Surgery Physician
  • Limerick, PA
National Provider Identifier
1790746345
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
PHOENIXVILLE CLINIC COMPANY LLC
Doing business as
Phoenixville Surgical Associates
Practice address
420 W Linfield Trappe Rd
Ste 1100
Limerick, PA 19468-4278
Phone
(610) 495-2550
Fax
(610) 495-2588
NPI assigned
Mar 31, 2006
Last updated
Mar 26, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PHOENIXVILLE CLINIC COMPANY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Authorized official

Name
Gary Conner
Title
VP & Cfo
Phone
(484) 628-8181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X Primary

Addresses

Primary practice location

420 W Linfield Trappe Rd
Ste 1100
Limerick, PA 19468-4278

Mailing address

PO Box 13579
Reading, PA 19612-3579

Other names 1

  • Phoenixville Surgical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060606000128 PA Part B Supplier - Clinic/Group Practice 5799796850 Receives reassigned benefits from 565 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Audubon, PA; Royersford, PA; Pottstown, PA; Phoenixville, PA; Philadelphia, PA; Norristown, PA; Limerick, PA; Collegeville, PA

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Part of
Phoenixville Clinic Company LLC

Locations

19 W Linfield Trappe Rd
Limerick, PA 19468
Phone (484) 948-2800

824 Main St
Ste 206
Phoenixville, PA 19460
Phone (610) 983-1010

824 Main St
Ste 300
Phoenixville, PA 19460
Phone (215) 935-7772

824 Main St
Ste 304
Phoenixville, PA 19460
Phone (610) 935-7772

420 W Linfield Trappe Rd
Ste 1100
Royersford, PA 19468
Phone (610) 495-2550

420 W Linfield Trappe Rd
Ste 3200
Royersford, PA 19468
Phone (610) 495-2550

Practitioners & affiliated clinicians

Practitioners 563

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.

View all 563

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553558400000",
    "number": "1790746345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W LINFIELD TRAPPE RD",
            "address_2": "STE 1100",
            "city": "LIMERICK",
            "state": "PA",
            "postal_code": "194684278",
            "telephone_number": "610-495-2550",
            "fax_number": "610-495-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIXVILLE CLINIC COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOENIXVILLE CLINIC COMPANY LLC",
        "enumeration_date": "2006-03-31",
        "last_updated": "2019-03-26",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "VP & CFO",
        "authorized_official_telephone_number": "484-628-8181"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenixville Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phoenixville Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Limerick, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.