Pediatric and Adolescent Medicine Group

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

PEDIATRIC AND ADOLESCENT MEDICINE GROUP

Practice address

2129 W Oregon Ave
First Floor Rear
Philadelphia, PA 19145-4131

Phone

(215) 462-6106

Fax

(215) 462-5922

NPI assigned

Jun 8, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Stella C Magliocco

Title

Office Manager

Phone

215462616

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sharon M Elvey, M.D.

  • Pediatric Adolescent Medicine Physician
  • Philadelphia, PA
  • NPI 1851360101
  NPD (past)
• Glenn Howard Pisk, M.D.

  • Pediatric Adolescent Medicine Physician
  • Philadelphia, PA
  • NPI 1114971066
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1801836671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129 W OREGON AVE",
            "address_2": "FIRST FLOOR REAR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454131",
            "telephone_number": "215-462-6106",
            "fax_number": "215-462-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 W OREGON AVE",
            "address_2": "FIRST FLOOR REAR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454131",
            "telephone_number": "215-462-6106",
            "fax_number": "215-462-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND ADOLESCENT MEDICINE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MAGLIOCCO",
        "authorized_official_first_name": "STELLA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "215462616",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greg Pedegana, CRNA
• Heather M. Pederson, PH.D.
• Courtney Day Pederzani, PSY.D.
• Lisa Pedevillano, DO
• Pediatric & Preventive Medicine Assoc PC
• Pediatric Dental Assoc LTD
• Pediatric Dental Assoc LTD
• Pediatric Dental Assoc., LTD
• Pediatric Dental Associates LTD
• Pediatric Dental Associates, LTD

• Pediatric Adolescent Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Adolescent Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.