University of Penn-Medical Group

Organization Active NPI Transplant Surgery Physician · Lancaster, PA

NPI 1902269210 · NPPES record last updated Nov 20, 2020

Key facts

NPI
1902269210
Entity type
Organization (NPI type 2)
Primary specialty
Transplant Surgery Physician 204F00000X
Legal business name
UNIVERSITY OF PENN-MEDICAL GROUP
Practice address
554 N Duke St
3Rd Floor
Lancaster, PA 17602-2225
Phone
(215) 662-6200
Fax
(215) 662-2244
NPI assigned
Apr 4, 2016
Organization subpart
No

Authorized official

Name
Chante L Jackson
Title
Enrollment Lead
Phone
(215) 662-6187

Other NPIs on the same Medicare enrollment 4

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

Corporate family (same tax ID) 23

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

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20150221000124 PA Part B Supplier - Clinic/Group Practice 6204730955 Receives reassigned benefits from 127 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Allentown, PA; Yardley, PA; Radnor, PA; Philadelphia, PA; Lancaster, PA

National Provider Directory

Tax ID family
Cobius Healthcare Solutions (24 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
204F00000X PA Yes
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208600000X PA
Vascular Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2086S0129X PA

Addresses

Primary practice location

554 N Duke St
3Rd Floor
Lancaster, PA 17602-2225

Mailing address

554 N Duke St
3Rd Floor
Lancaster, PA 17602-2225
Phone (215) 662-6200

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Other providers in Lancaster, PA

All providers in Lancaster, PA · Transplant Surgery Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.