120 Rider Avenue Operating Company, LP

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

328590 Issued in PA

Legal business name

120 RIDER AVENUE OPERATING COMPANY, LP

Doing business as

Pediatric Specialty Care at Lancaster

Practice address

120 Rider Ave
Lancaster, PA 17603-4831

Phone

(717) 394-0882

NPI assigned

Feb 16, 2011

Last updated

Sep 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Kenworthy

Title

Sr. Director Revenue Cycle MGMT

Phone

(716) 361-6636

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Pediatric Specialty Care at Lancaster Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Harry P Bramley, DO

  • Pediatrics Physician
  • Hershey, PA
  • NPI 1598715088
  NPD (past)
• Emily Marie Gray Goerl, DO

  • Pediatrics Physician
  • Lancaster, PA
  • NPI 1598145401
  NPD (past)
• Agnes Megumi Tsuda, MD

  • Student in an Organized Health Care Education/Training Program
  • Wilmington, DE
  • NPI 1942882626
  NPD (past)

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1992002505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SENECA ST STE 100",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142041963",
            "telephone_number": "716-361-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 RIDER AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176034831",
            "telephone_number": "717-394-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "120 RIDER AVENUE OPERATING COMPANY, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-16",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "KENWORTHY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SR. DIRECTOR REVENUE CYCLE MGMT",
        "authorized_official_telephone_number": "716-361-6636"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "PA",
            "license": "328590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE",
            "identifier": "328590",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE",
            "identifier": "328690",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Specialty Care at Lancaster",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Care Agency in Lancaster, PA
• Providers in Lancaster, PA by specialty
• Nursing Care Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.