NPIMap

Organization Active NPI

Kensington Hospital- Clinic

  • Primary Care Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1902955586
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
111101 Issued in PA
Legal business name
KENSINGTON HOSPITAL- CLINIC
Practice address
136 Diamond St
Philadelphia, PA 19122-1721
Phone
(215) 426-8100
Fax
(215) 965-2344
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Authorized official

Name
Ms. Eileen Hause, M.B.A.
Title
Chief Executive Officer
Phone
(215) 426-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 111101 PA Primary

Addresses

Primary practice location

136 Diamond St
Philadelphia, PA 19122-1721

Mailing address

136 Diamond St
Philadelphia, PA 19122-1721
Phone (215) 426-8100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420000239 PA Part B Supplier - Clinic/Group Practice 6305831165 Receives reassigned benefits from 8 practitioners
2 other NPIs on this enrollment
Practice locations: Philadelphia, PA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Kensington Hospital- Congreso Clinic13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kensington HospitalPhiladelphia, PA, CCN 390025 Hospital Operational/Managerial Control (100%) Jul 1, 1966

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 8

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": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454976000000",
    "number": "1902955586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 DIAMOND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191221721",
            "telephone_number": "215-426-8100",
            "fax_number": "215-965-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 DIAMOND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191221721",
            "telephone_number": "215-426-8100",
            "fax_number": "215-965-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENSINGTON HOSPITAL- CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2016-02-09",
        "status": "A",
        "authorized_official_last_name": "HAUSE",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "215-426-8100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.B.A."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PA",
            "license": "111101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.