NPIMap

Organization Active NPI

Peter Vassalluzzo D.O.

Doing business as Lawndale Medical Associates

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1871656009
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS-006575L Issued in PA
Legal business name
PETER VASSALLUZZO D.O.
Doing business as
Lawndale Medical Associates
Practice address
6190 Rising Sun Ave
Philadelphia, PA 19111-6011
Phone
(215) 725-8111
Fax
(215) 742-9501
NPI assigned
Dec 19, 2006
Last updated
Mar 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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

Authorized official

Name
Dr. Peter Vassalluzzo, DONPI 1750311148
Title
Physician
Phone
(215) 725-8111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS-006575L PA Primary

Addresses

Primary practice location

6190 Rising Sun Ave
Philadelphia, PA 19111-6011

Mailing address

6190 Rising Sun Ave
Philadelphia, PA 19111-6011
Phone (215) 725-8111

Other identifiers 1

IdentifierTypeStateIssuer
0543451000OtherPAKEYSTONE

Other names 1

  • Lawndale Medical Associates Doing business as

National Provider Directory

National Provider Directory

Locations

6190 Rising Sun Ave
Philadelphia, PA 19111
Phone (215) 725-8111

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1871656009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6190 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191116011",
            "telephone_number": "215-725-8111",
            "fax_number": "215-742-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6190 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191116011",
            "telephone_number": "215-725-8111",
            "fax_number": "215-742-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER VASSALLUZZO D.O.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "VASSALLUZZO",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "215-725-8111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS-006575L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0543451000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lawndale Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; 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.