Merakey Woodhaven

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

MERAKEY WOODHAVEN

Practice address

2900 Southampton Rd
Philadelphia, PA 19154-1202

Phone

(215) 836-3131

Fax

(215) 273-5975

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Norman E Tilson Jr.

Title

Corp Sr. Director of Business Ops

Phone

(215) 836-3131

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• NHS Woodhaven Former legal business name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790908853. Details of each certification follow.

• CCN 39G020 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 39G020

Legal name

MERAKEY WOODHAVEN

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Nov 1, 1982

Last certification

Jul 31, 2024

Beds

31

Ownership / control type

Private (non-profit)

Facility address

2900 Southampton Rd
Philadelphia, PA 19154

Tax ID family

Merakey Woodhaven4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Merakey Woodhaven

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1073717591
  NPD tax ID
• Merakey Woodhaven

  • Community/Behavioral Health Agency
  • Lafayette Hill, PA
  • NPI 1215441530
  NPD tax ID
• Merakey Woodhaven

  • Clinic/Center
  • Lafayette Hill, PA
  • NPI 1861408692
  NPD tax ID

Locations

Practitioners 1

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.

• Richard Grant, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Philadelphia, PA
  • NPI 1427001684
  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1790908853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 GERMANTOWN PIKE",
            "city": "LAFAYETTE HILL",
            "state": "PA",
            "postal_code": "194441810",
            "telephone_number": "215-836-3131",
            "fax_number": "215-273-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 SOUTHAMPTON RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191541202",
            "telephone_number": "215-836-3131",
            "fax_number": "215-273-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERAKEY WOODHAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "TILSON",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CORP SR. DIRECTOR OF BUSINESS OPS",
        "authorized_official_telephone_number": "215-836-3131",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000015750039",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NHS Woodhaven",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "NHS Woodhaven",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Merakey Philadelphia
• Merakey Total Health
• Merakey Total Health
• Merakey Total Health
• Merakey Woodhaven
• Meraki Essential Health LLC
• Mark Meraner, DDS
• Alyssa Lauren Merback, MS CCC-SLP
• Mercado Medical Practice LLC
• Max E. Mercado, M.D.

• Intellectual Disabilities Intermediate Care Facility in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Intellectual Disabilities Intermediate Care Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.