NPIMap

Organization Active NPI

Kensington Hospital

  • Methadone Clinic
  • Philadelphia, PA
National Provider Identifier
1851745566
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
KENSINGTON HOSPITAL
Practice address
2100 N Front St
Philadelphia, PA 19122-1705
Phone
(215) 426-8100
Fax
(267) 861-6410
NPI assigned
Apr 19, 2016
Organization subpart
Yes
Parent organization
KENSINGTON HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Authorized official

Name
Kathleen Lalli, MSN, RN
Title
Chief Executive Officer
Phone
(215) 426-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X PA Primary

Addresses

Primary practice location

2100 N Front St
Philadelphia, PA 19122-1705

Mailing address

2100 N Front St
Philadelphia, PA 19122-1705
Phone (215) 426-8100

Other identifiers 1

IdentifierTypeStateIssuer
1007717290021MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Opioid treatment program
Medicare-enrolled since Jan 1, 2023

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230223000056 PA Part B Supplier - Opioid Treatment Program (Otp) 6305831165 Practice locations: Philadelphia, PA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2335593Kensington Hospital Outpt TX Pro2100 N Front St, Philadelphia, PA 19122Certificate of waiverDec 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
Anesthesiology Kensingt13 organizations share this tax ID, including this one
Part of
Anesthesiology Kensingt

Other organizations with this tax ID 12

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

Locations

2100 N Front St
Philadelphia, PA 19122
Phone (215) 425-8100

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kensington HospitalPhiladelphia, PA, CCN 390025 Hospital Operational/Managerial Control (100%) Jul 1, 1966

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 10

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": "1461024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1851745566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N FRONT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191221705",
            "telephone_number": "215-426-8100",
            "fax_number": "267-861-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N FRONT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191221705",
            "telephone_number": "215-426-8100",
            "fax_number": "267-861-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENSINGTON HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENSINGTON HOSPITAL",
        "enumeration_date": "2016-04-19",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "LALLI",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "215-426-8100",
        "authorized_official_credential": "MSN, RN"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007717290021",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.