NPIMap

Individual provider Active NPI

Christy Herrera

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1851940399
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA062001 Issued in PA
Practice address
3400 Spruce Street
Ground Floor Donner
Philadelphia, PA 19104-4206
Phone
(904) 885-6450
NPI assigned
Sep 7, 2019
Last updated
Apr 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA062001 PA Primary

Addresses

Primary practice location

3400 Spruce Street
Ground Floor Donner
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce Street
Ground Floor Donner
Philadelphia, PA 19104-4206
Phone (904) 885-6450

Other practice location 1

4170 City Ave
Philadelphia, PA 19131-1610
Phone (215) 871-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211007002467 PA Practitioner - Physician Assistant 3476951328 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4206

3400 Spruce Street 5 White BLDG
Oral and Maxillofacial Surgery Hup
Philadelphia, PA 19104-4206
Phone (215) 829-6079

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA062001PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fornance Physician Services, Inc CurrentSince Dec 1, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 22, 2024 Accepting new patients
Einstein Practice Plan Inc CurrentSince Oct 1, 2021 Accepting new patients
Einstein Practice Plan Inc CurrentSince Oct 1, 2021 Accepting new patients
Fornance Physician Services, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

559 W Germantown Pike
West Norriton, PA 19403
Phone (484) 622-1000

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1567814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1851940399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "GROUND FLOOR DONNER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "904-885-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "GROUND FLOOR DONNER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "904-885-6450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4170 City Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191311610",
            "country_code": "US",
            "telephone_number": "215-871-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "CHRISTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-07",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.