Mercy Management of Southeastern Pennsylvania

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

License

MD047458 Issued in PA

Legal business name

MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA

Practice address

501 S 54TH St
Suite 28
Philadelphia, PA 19143-1900

Phone

(215) 748-9822

Fax

(215) 748-9717

NPI assigned

Dec 20, 2005

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 2

Addresses

Other identifiers 7

Other names 1

• MMS-Mercy Orthpaedics Associates Doing business as

Locations

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1891771994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "address_2": "2ND 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 28",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431900",
            "telephone_number": "215-748-9822",
            "fax_number": "215-748-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2008-05-09",
        "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": "207XS0114X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "PA",
            "license": "MD047458",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "PA",
            "license": "MD042497",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007787930159",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "1251834000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2957200",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KERYSTONE MERCY HEALTH PL",
            "identifier": "30010804",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1544388",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "2228682000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "33316",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMS-Mercy Orthpaedics Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mercy Management of Southeastern Pennsylvania
• Mercy Management of Southeastern Pennsylvania
• Mercy Management of Southeastern Pennsylvania
• Mercy Management of Southeastern Pennsylvania
• Mercy Management of Southeastern Pennsylvania
• Mercy Management of Southeastern Pennsylvania
• Mercy Neighborhood Ministries of Philadelphia, Inc
• Mercyfull Home Health Inc,
• Nicole T Merena
• Stacy Ann Merenda, PHARMD

• Adult Reconstructive Orthopaedic Surgery Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.