Trinity Health Mid-Atlantic Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP

Practice address

501 Street Rd
Suite 100
Southampton, PA 18966

Phone

(215) 322-6060

Fax

(215) 322-6099

NPI assigned

Oct 9, 2015

Organization subpart

No

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

Authorized official

Name

Sharon Profera

Title

Director of Finance

Phone

(215) 710-2013

Specialties & licenses 1

Addresses

Other names 1

• Southampton St. Mary Family Practice Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 4

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

• Theresa J Davies, ARNP

  • Family Nurse Practitioner
  • Lower Gwynedd, PA
  • NPI 1144311267
  NPD
• Fozia Farooqui, M.D.

  • Hospitalist Physician
  • Langhorne, PA
  • NPI 1083794226
  NPD
• Jeffrey Scott Veluz, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Allentown, PA
  • NPI 1578526158
  NPD
• Daniel Tran, DO

  • Interventional Cardiology Physician
  • Camden, NJ
  • NPI 1477081396
  NPD

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703635200000",
    "number": "1841661378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 UNIVERSITY DR",
            "address_2": "SUITE 300",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401873",
            "telephone_number": "215-710-5522",
            "fax_number": "215-710-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 STREET RD",
            "address_2": "SUITE 100",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "18966",
            "telephone_number": "215-322-6060",
            "fax_number": "215-322-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-09",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "PROFERA",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "215-710-2013"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southampton St. Mary Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southampton St. Mary Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tri County Optometric
• Tri County Surgery Center LLC
• Tri-Century Eye Care, PC
• Tri-Century Eye Care, PC
• Trinity Health Mid-Atlantic Medical Group
• Alli Trotto
• David J. Trumbore, MD
• Alina Tsirelson, LPC
• Roshell Tverskaya
• Urgent Care Clinic PLLC

• Family Medicine Physician in Southampton, PA
• Providers in Southampton, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.