NPIMap

Individual provider Active NPI

Kaitlin Elizabeth O'Malley, MD

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1922563089
Registry record updated Feb 4, 2019
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Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MT217175 Issued in PA
Practice address
10 Shurs LN Ste 203
Philadelphia, PA 19127-2123
Phone
(215) 482-1234
Fax
(215) 482-1095
NPI assigned
Feb 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT217175 PA Primary

Addresses

Primary practice location

10 Shurs LN Ste 203
Philadelphia, PA 19127-2123

Mailing address

10 Shurs LN Ste 203
Philadelphia, PA 19127-2123
Phone (215) 482-1234

Other practice location 1

230 N Broad St # 623
Philadelphia, PA 19102-1121
Phone (263) 276-2215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220411000890 PA Practitioner - Family Practice 7113313628 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Drexel University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

1000 Easton Rd
Wyncote, PA 19095-2918
Phone (215) 707-2098

Hospital & facility affiliations

  • Temple Health - Chestnut Hill Hospital Hospital, Philadelphia, PA, CCN 390026
  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027
  • Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT217175PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Sep 11, 2023 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Tower Drexel Academic Medical Group LLC Current Accepting new patients
Chestnut Hill Clinic Company, LLC CurrentSince Nov 30, 2022 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Sep 11, 2023 Accepting new patients
Chestnut Hill Clinic Company, LLC Family Medicine CurrentSince Nov 30, 2022 Accepting new patients
Tower Drexel Academic Medical Group LLC CurrentSince Apr 5, 2022 Accepting new patients
CHH Community Health Past Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients

Locations

3401 Market St
Ste 105A
Philadelphia, PA 19104
Phone (215) 220-4720

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

10 Shurs Ln
Philadelphia, PA 19127
Phone (215) 482-0899

219 N Broad St
Fl 6
Philadelphia, PA 19107
Phone (215) 762-5037

1331 E Wyoming Ave
Philadelphia, PA 19124
Phone (215) 537-7400

10 Shurs Ln
Ste 203
Philadelphia, PA 19127
Phone (215) 482-1234

1000 Easton Rd
Ste 260
Wyncote, PA 19095
Phone (215) 884-8815

8200 Flourtown Ave
Ste 2
Wyndmoor, PA 19038
Phone (215) 836-5100

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1922563089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SHURS LN STE 203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191272123",
            "telephone_number": "215-482-1234",
            "fax_number": "215-482-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SHURS LN STE 203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191272123",
            "telephone_number": "215-482-1234",
            "fax_number": "215-482-1095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 N Broad St # 623",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191021121",
            "country_code": "US",
            "telephone_number": "263-276-2215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "KAITLIN",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT217175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.