NPIMap

Organization Active NPI

Penn Presbyterian Medical Center

  • Case Management Agency
  • Philadelphia, PA
National Provider Identifier
1952949083
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
PENN PRESBYTERIAN MEDICAL CENTER
Practice address
4040 Market Street
Suite 200
Philadelphia, PA 19104
Phone
(215) 662-8884
Fax
(215) 662-8908
NPI assigned
Dec 19, 2019
Last updated
Dec 19, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PENN PRESBYTERIAN MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Authorized official

Name
Mr. Thomas Michael McCormick Jr.
Title
VP-Patient Accounting
Phone
(215) 762-0888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU Primary

Addresses

Primary practice location

4040 Market Street
Suite 200
Philadelphia, PA 19104

Mailing address

4040 Market Street
Suite 200
Philadelphia, PA 19104
Phone (215) 662-8884

Other identifiers 1

IdentifierTypeStateIssuer
1007297070008MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Penn Presbyterian Medical Center Spu15 organizations share this tax ID, including this one
Part of
Penn Presbyterian Medical Center Spu

Other organizations with this tax ID 14

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

View all 14

Locations

4040 Market St
Ste 200
Philadelphia, PA 19104
Phone (215) 662-8884

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1952949083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 MARKET STREET",
            "address_2": "SUITE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-8884",
            "fax_number": "215-662-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 MARKET STREET",
            "address_2": "SUITE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-8884",
            "fax_number": "215-662-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN PRESBYTERIAN MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN PRESBYTERIAN MEDICAL CENTER",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "VP-PATIENT ACCOUNTING",
        "authorized_official_telephone_number": "215-762-0888",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007297070008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.