Presbyterian Medical Center of the University of Pennsylvania Health S

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00752100 Issued in NJ

Legal business name

PRESBYTERIAN MEDICAL CENTER OF THE UNIVERSITY OF PENNSYLVANIA HEALTH S

Practice address

1865 Route 70 E
Cherry Hill, NJ 08003-2005

Phone

(856) 433-2877

Fax

(856) 396-3416

NPI assigned

Oct 26, 2016

Organization subpart

No

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

Authorized official

Name

Nishaminy Kasbekar

Title

Director of Pharmacy

Phone

(215) 662-8213

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Penn Medicine Cherry Hill Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

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

• Presbyterian Medical Center of the University of Pennsylvania Health S

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1245207521

  0042115008

  Same PAC ID
• Presbyterian Medical Center of the University of Pennsylvania Health S

  • Community/Retail Pharmacy
  • Philadelphia, PA
  • NPI 1801202817

  0042115008

  Same PAC ID
• Presbyterian Medical Center of the University of Pennsylvania Health S

  • Home Health Agency
  • Bala Cynwyd, PA
  • NPI 1992746366

  0042115008

  Same PAC ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Trustees of the University of Pennsylvania

  • Community/Retail Pharmacy
  • Radnor, PA
  • NPI 1922029982

  Member Of

  NPD member

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Presbyterian Medical Center of the University of Pennsylvania Health S

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1245207521

  Operational/Managerial Control

  CMS ownership

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Hopely

  • Pharmacist
  • Cherry Hill, NJ
  • NPI 1518884758
  NPD (past)
• ABA Y Barden-Maja, MD

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1356371413
  NPD (past)
• Robert Keith Cato, MD

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1881626174
  NPD (past)
• Jack Ende, MD

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1730110412
  NPD (past)
• Saige Xueqi Fang, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Philadelphia, PA
  • NPI 1538820592
  NPD (past)
• Franz Fogt, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Philadelphia, PA
  • NPI 1376590257
  NPD (past)
• Laura M Kosseim, MD

  • Hospitalist Physician
  • Philadelphia, PA
  • NPI 1912933607
  NPD (past)

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1982156824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 ROUTE 70 E",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032005",
            "telephone_number": "856-433-2877",
            "fax_number": "856-396-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN MEDICAL CENTER OF THE UNIVERSITY OF PENNSYLVANIA HEALTH S",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "KASBEKAR",
        "authorized_official_first_name": "NISHAMINY",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "215-662-8213"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00752100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2165910",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Medicine Cherry Hill Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Penn Medicine Cherry Hill Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premier Cadbury LLC
• Premier Cadbury, LLC
• Premier Family Practice LLC
• Premier Immediate Medical Care, LLC Premier Urgent Care
• Premier Orthopaedic and Sports Medicine Assoc of Southern NJ LLC
• Prestige Institute for Plastic Surgery, P.C.
• Price Social Services, Inc.
• Price Social Services, Inc.
• Jacqueline Anne Price, BA
• Samantha Jean Marie Price, MS

• All providers in Cherry Hill, NJ
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.