Active NPI
Elwyn of Pennsylvania and Delaware
- Intellectual Disabilities Intermediate Care Facility
- Elwyn, PA
National Provider Identifier
1801936927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- Legal business name
- ELWYN OF PENNSYLVANIA AND DELAWARE
- Practice address
- 111 Elwyn Rd
Icf Mr Adult Residential
Elwyn, PA 19063-4622 - Phone
- (610) 891-7692
- NPI assigned
- Feb 7, 2007
- Last updated
- May 6, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Donna K Busch
- Title
- Dir Contracting and Credentialing
- Phone
- (452) 063-0284
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | Primary |
Addresses
Primary practice location
111 Elwyn Rd
Icf Mr Adult Residential
Elwyn, PA 19063-4622
Mailing address
111 Elwyn Rd
Icf Mr Adult Residential
Elwyn, PA 19063-4622
Phone (610) 891-7692
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000021240254 | Medicaid | PA |
Other names 1
- ICF MR ADULT MAIN CAMPUS
Medicare participation
Medicare enrollment files- 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 1801936927. Details of each certification follow.
Intermediate care facility for individuals with intellectual disabilities certification: CCN 39G128
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- ELWYN OF PENNSYLVANIA AND DELAWARE - MEDIA CAMPUS
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Jun 27, 1986
- Last certification
- Jun 6, 2025
- Beds
- 65
- Ownership / control type
- Private (non-profit)
- Facility address
- 111 Elwyn Road
Elwyn, PA 19063
National Provider Directory
National Provider Directory- Tax ID family
- Elwyn
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Clinic/Center
- Elwyn, PA
- NPI 1669637898
-
- Community/Behavioral Health Agency
- Elwyn, PA
- NPI 1689870545
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Elwyn, PA
- NPI 1700926847
-
- Community/Behavioral Health Agency
- Elwyn, PA
- NPI 1720128390
-
- Community/Behavioral Health Agency
- Elwyn, PA
- NPI 1760522007
-
- Community/Behavioral Health Agency
- Elwyn, PA
- NPI 1770789638
-
- Clinic/Center
- Allentown, PA
- NPI 1780811372
-
- Mental Illness Community Based Residential Treatment Facility
- Elwyn, PA
- NPI 1831391846
-
- Intellectual Disabilities Intermediate Care Facility
- Elwyn, PA
- NPI 1861525693
-
- Community/Behavioral Health Agency
- Philadelphia, PA
- NPI 1902072358
-
- Community/Behavioral Health Agency
- Elwyn, PA
- NPI 1902946577
-
- Community/Behavioral Health Agency
- Elwyn, PA
- NPI 1952441404
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Geriatric Medicine (Family Medicine) Physician
- Elwyn, PA
- NPI 1467431635
-
- Internal Medicine Physician
- Plymouth Meeting, PA
- NPI 1063476661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714953600000",
"number": "1801936927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 ELWYN RD",
"address_2": "ICF MR ADULT RESIDENTIAL",
"city": "ELWYN",
"state": "PA",
"postal_code": "190634622",
"telephone_number": "610-891-7692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 ELWYN RD",
"address_2": "ICF MR ADULT RESIDENTIAL",
"city": "ELWYN",
"state": "PA",
"postal_code": "190634622",
"telephone_number": "610-891-7692"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELWYN OF PENNSYLVANIA AND DELAWARE",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-07",
"last_updated": "2024-05-06",
"certification_date": "2024-05-06",
"status": "A",
"authorized_official_last_name": "BUSCH",
"authorized_official_first_name": "DONNA",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "DIR CONTRACTING AND CREDENTIALING",
"authorized_official_telephone_number": "452-063-0284"
},
"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": "1000021240254",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ICF MR ADULT MAIN CAMPUS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Elwyn, PA
- Elwyn of Pennsylvania and Delaware
- Elwyn of Pennsylvania and Delaware
- Elwyn of Pennsylvania and Delaware
- Elwyn of Pennsylvania and Delaware
- Elwyn of Pennsylvania and Delaware
- Elwyn of Pennsylvania and Delaware
- Elwyn of Pennsylvania and Delaware (Elwyn Adult Crisis Residential)
- Elwyn of Pennsylvania and Delaware
- Elwyn of Pennsylvania and Delaware
- Elwyn of Pennsylvania and Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.