NPIMap

Organization Active NPI

Trinity Health Mid-Atlantic Medical Group

  • Family Medicine Physician
  • Levittown, PA
National Provider Identifier
1982910931
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS006458E Issued in PA
Legal business name
TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP
Practice address
1609 Woodbourne Rd Ste 101
Inactive DO Not Use This One
Levittown, PA 19057
Phone
(215) 945-1500
Fax
(215) 945-9192
NPI assigned
Aug 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Authorized official

Name
Danielle C Clarke
Title
Regional VP
Phone
(215) 710-6542

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS006458E PA Primary

Addresses

Primary practice location

1609 Woodbourne Rd Ste 101
Inactive DO Not Use This One
Levittown, PA 19057

Mailing address

41 University Drive
Suite 300
Newtown, PA 18940-1873
Phone (215) 710-5522

Other names 1

  • WOODBOURNE FAMILY PRACTICE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326000613 PA Part B Supplier - Clinic/Group Practice 7416861885 Receives reassigned benefits from 703 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
LPS-Cardiology38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

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

View all 37

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1982910931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 UNIVERSITY DRIVE",
            "address_2": "SUITE 300",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401873",
            "telephone_number": "215-710-5522",
            "fax_number": "215-710-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 WOODBOURNE RD STE 101",
            "address_2": "INACTIVE DO NOT USE THIS ONE",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "19057",
            "telephone_number": "215-945-1500",
            "fax_number": "215-945-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "REGIONAL VP",
        "authorized_official_telephone_number": "215-710-6542"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006458E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOODBOURNE FAMILY PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Levittown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.