Mercy Management of Sepa

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

MERCY MANAGEMENT OF SEPA

Doing business as

MMS-Leon Clarke, MD

Practice address

501 S 54TH St
Suite 537
Philadelphia, PA 19143-1900

Phone

(215) 748-9653

Fax

(215) 748-9667

NPI assigned

Dec 20, 2005

Last updated

Jun 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Douglas C Smith

Title

VP Financial Services

Phone

(610) 567-6964

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• MMS-Leon Clarke, MD Doing business as

Locations

Practitioners 2

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.

• Leon E Clarke, MD

  • Surgery Physician
  • Darby, PA
  • NPI 1295717221
  NPD (past)
• John B Fobia, MD

  • Surgery Physician
  • Philadelphia, PA
  • NPI 1760472492
  NPD (past)

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1861478976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "address_2": "2 ND FLOOR",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282007",
            "telephone_number": "610-567-6964",
            "fax_number": "610-567-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 54TH ST",
            "address_2": "SUITE 537",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431900",
            "telephone_number": "215-748-9653",
            "fax_number": "215-748-9667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MANAGEMENT OF SEPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP FINANCIAL SERVICES",
        "authorized_official_telephone_number": "610-567-6964",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "125182900",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "2227092000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY HEALTH PLA",
            "identifier": "30010808",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3032802",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007787930154",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4597364",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1542222",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMS-Leon Clarke, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mercy Management of Sepa (MMS-Mercy Geriatric Associates)
• Mercy Management of Sepa (West Philadelphia Women First)
• Mercy Management of Sepa (Mercy Specialty Assocates)
• Mercy Management of Sepa (Mercy Health Associates)
• Mercy Management of Sepa (Mercy Hospital of Philadelphia CRNP)
• Mercy Management of Sepa (MMSEPA P PCP 52nd Office)
• Mercy Management of Sepa (MMSEPA P PCP 54th Office)
• Mercy Management of Sepa (SEPA Multi - Specialty Group)
• Mercy Management of Southeastern Pennsylvani (MMSEPA P PCP Chestnut Office)
• Mercy Management of Southeastern Pennsylvani

• Surgery Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.