NPIMap

Organization Active NPI

Jefferson Community Physicians

  • Internal Medicine Physician
  • Bala Cynwyd, PA
National Provider Identifier
1891587036
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JEFFERSON COMMUNITY PHYSICIANS
Practice address
225 E City Line Ave
Bala Cynwyd, PA 19004-1704
Phone
(844) 542-2273
NPI assigned
May 22, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Rachel Renae Dantis
Title
Enterprise Direct Provider Enroll
Phone
(609) 238-7660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

225 E City Line Ave
Bala Cynwyd, PA 19004-1704

Mailing address

PO Box 828937
Philadelphia, PA 19182-8937
Phone (215) 503-1240

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040402000835 PA Part B Supplier - Clinic/Group Practice 6406755651 Receives reassigned benefits from 688 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA; Philadlephia, PA; Pittsburgh, PA; Rydal, PA; Upland, PA; Abington, PA; Bala Cynwyd, PA; Chalfont, PA…

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Methodist Practice Plan38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1891587036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 828937",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191828937",
            "telephone_number": "215-503-1240",
            "fax_number": "215-503-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CITY LINE AVE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041704",
            "telephone_number": "844-542-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COMMUNITY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "DANTIS",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "RENAE",
        "authorized_official_title_or_position": "ENTERPRISE DIRECT PROVIDER ENROLL",
        "authorized_official_telephone_number": "609-238-7660"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.