Mercy Management of Southeastern Pennsylvania

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA

Doing business as

Mercy Health Associates

Practice address

6323 Vine St
Philadelphia, PA 19139-1032

Phone

(215) 748-8303

Fax

(215) 748-8660

NPI assigned

Oct 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. Don Halberstadt

Title

Cfo

Phone

(610) 567-6964

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Mercy Health Associates Doing business as

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1932198157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "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": "6323 VINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191391032",
            "telephone_number": "215-748-8303",
            "fax_number": "215-748-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "HALBERSTADT",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "610-567-6964",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "2247379004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "36431",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA5351",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY HEALTH PLA",
            "identifier": "30010755",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007787930163",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1555770",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "61258870002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Health 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 Neighborhood Ministries of Philadelphia, Inc
• Mercyfull Home Health Inc,
• Nicole T Merena
• Stacy Ann Merenda, PHARMD
• Glenn Merewitz, M.D.

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.