Active NPI
Paula Alejandra Pino Pommer, M.D.
- General Practice Physician
- Philadelphia, PA
National Provider Identifier
1972072288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- LT000810
- Practice address
- 3551 North Broad St.
Philadelphia, PA 19140-4160 - Phone
- (215) 430-4022
- Fax
- (215) 430-4247
- NPI assigned
- Nov 15, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | LT000810 | PA | Primary |
Addresses
Primary practice location
3551 North Broad St.
Philadelphia, PA 19140-4160
Mailing address
3551 North Broad St.
Philadelphia, PA 19140-4160
Phone (215) 430-4022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LT000810 | PA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542240000000",
"number": "1972072288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 NORTH BROAD ST.",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191404160",
"telephone_number": "215-430-4022",
"fax_number": "215-430-4247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 NORTH BROAD ST.",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191404160",
"telephone_number": "215-430-4022",
"fax_number": "215-430-4247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINO POMMER",
"first_name": "PAULA ALEJANDRA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-15",
"last_updated": "2018-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PA",
"license": "LT000810",
"primary": true
}
],
"identifiers": [],
"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 Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.