Philadelphia Family Medical Associates

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS006489L Issued in PA

Legal business name

PHILADELPHIA FAMILY MEDICAL ASSOCIATES

Practice address

4702 N 5TH St
Philadelphia, PA 19120-4108

Phone

(215) 329-4888

Fax

(215) 329-5615

NPI assigned

Jun 13, 2006

Organization subpart

No

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

Authorized official

Name

Brian Walsh, D.O.NPI 1902845670

Title

President

Phone

(215) 329-4888

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Brian Walsh, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1902845670
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861434680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 N 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191204108",
            "telephone_number": "215-329-4888",
            "fax_number": "215-329-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 N 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191204108",
            "telephone_number": "215-329-4888",
            "fax_number": "215-329-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA FAMILY MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-329-4888",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006489L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.