NPIMap

Organization Active NPI

Keystone Hospice

Doing business as KeystoneCare Palliative Care Program

  • Internal Medicine Physician
  • Wyndmoor, PA
National Provider Identifier
1912285198
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
KEYSTONE HOSPICE
Doing business as
KeystoneCare Palliative Care Program
Practice address
8765 Stenton Ave
Wyndmoor, PA 19038-8317
Phone
(215) 836-2440
Fax
(215) 836-2509
NPI assigned
Jul 22, 2011
Last updated
Nov 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Authorized official

Name
Gail Inderwies
Title
President
Phone
(215) 836-2440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X PA Primary

Addresses

Primary practice location

8765 Stenton Ave
Wyndmoor, PA 19038-8317

Mailing address

8765 Stenton Ave
Wyndmoor, PA 19038-8317
Phone (215) 836-2440

Other names 1

  • KeystoneCare Palliative Care Program Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111121000421 PA Part B Supplier - Clinic/Group Practice 3274578240 Receives reassigned benefits from 15 practitioners
Practice locations: Wyndmoor, PA; Philadelphia, PA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Keystone Hospice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

8765 Stenton Ave
Wyndmoor, PA 19038
Phone (215) 836-2440

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321833600000",
    "number": "1912285198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8765 STENTON AVE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190388317",
            "telephone_number": "215-836-2440",
            "fax_number": "215-836-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8765 STENTON AVE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190388317",
            "telephone_number": "215-836-2440",
            "fax_number": "215-836-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-22",
        "last_updated": "2011-11-21",
        "status": "A",
        "authorized_official_last_name": "INDERWIES",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-836-2440"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KeystoneCare Palliative Care Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wyndmoor, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; 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.