NPIMap

Organization Active NPI

Prospect Health Access Network, Inc.

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, PA
National Provider Identifier
1871948414
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
PROSPECT HEALTH ACCESS NETWORK, INC.
Practice address
190 W Sproul Rd
Suite 102
Springfield, PA 19064-2027
Phone
(610) 338-1820
Fax
(610) 338-1825
NPI assigned
May 2, 2016
Last updated
Jan 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Authorized official

Name
Robert Jon Elders
Title
Secretary
Phone
(714) 788-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary

Addresses

Primary practice location

190 W Sproul Rd
Suite 102
Springfield, PA 19064-2027

Mailing address

190 W Sproul Rd
Suite 102
Springfield, PA 19064-2027
Phone (610) 338-1820

Other names 1

  • Endocrinology Associates Springfield Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160613000737 PA Part B Supplier - Clinic/Group Practice 5698065142 Receives reassigned benefits from 730 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory
Tax ID family
Crozer Health Medical Group14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

500 Evergreen Dr
Ste 23
Glen Mills, PA 19342
Phone (610) 579-3630

1220 Chester Pike
Sharon Hill, PA 19079
Phone (610) 586-2122

190 W Sproul Rd
Ste 102
Springfield, PA 19064
Phone (610) 338-1820

1324 Macdade Blvd
Woodlyn, PA 19094
Phone (610) 872-2200

Practitioners & affiliated clinicians

Practitioners 37

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.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610668800000",
    "number": "1871948414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 W SPROUL RD",
            "address_2": "SUITE 102",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642027",
            "telephone_number": "610-338-1820",
            "fax_number": "610-338-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 W SPROUL RD",
            "address_2": "SUITE 102",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642027",
            "telephone_number": "610-338-1820",
            "fax_number": "610-338-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT HEALTH ACCESS NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-02",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A",
        "authorized_official_last_name": "ELDERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "714-788-1249"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endocrinology Associates Springfield",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Endocrinology Associates Springfield",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Springfield, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.