NPIMap

Organization Active NPI

Family Practice Associates of Upper Dublin

  • Family Medicine Physician
  • Fort Washington, PA
National Provider Identifier
1811921166
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY PRACTICE ASSOCIATES OF UPPER DUBLIN
Practice address
1244 Fort Washington Ave
Ste E2
Fort Washington, PA 19034
Phone
(215) 646-1686
Fax
(215) 628-4956
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Raynetta Wallace
Title
Operations Manager
Phone
(267) 468-7462

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1244 Fort Washington Ave
Ste E2
Fort Washington, PA 19034

Mailing address

1244 Fort Washington Ave Ste E2
Fort Washington, PA 19034-1743
Phone (215) 646-1686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040621000613 PA Part B Supplier - Clinic/Group Practice 1850376211 Receives reassigned benefits from 9 practitioners
Practice locations: Fort Washington, PA

National Provider Directory

National Provider Directory

Locations

1244 Fort Washington Ave
Ste 2
Fort Washington, PA 19034

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BEFDBD

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1811921166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 FORT WASHINGTON AVE STE E2",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190341743",
            "telephone_number": "215-646-1686",
            "fax_number": "215-692-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 FORT WASHINGTON AVE",
            "address_2": "STE E2",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "19034",
            "telephone_number": "215-646-1686",
            "fax_number": "215-628-4956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE ASSOCIATES OF UPPER DUBLIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "RAYNETTA",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "267-468-7462"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.