NPIMap

Organization Active NPI

Presbyterian Medical Center of the University of Pennsylvania Health S

  • Home Health Agency
  • Bala Cynwyd, PA
National Provider Identifier
1992746366
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
712505 Issued in PA
Legal business name
PRESBYTERIAN MEDICAL CENTER OF THE UNIVERSITY OF PENNSYLVANIA HEALTH S
Practice address
150 Monument Rd
Suite 300
Bala Cynwyd, PA 19004-1725
Phone
(610) 747-3400
Fax
(610) 747-3479
NPI assigned
Jun 9, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. James Weinstein
Title
Cfo Penn Home Care & Hospice
Phone
(610) 747-3400

Owners & managing parties with NPI records 14

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 14

Owned or controlled facilities with NPI records 1

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

Other NPIs with the same Medicare PAC ID 3

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

Member of 1

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

Facilities with the same owner 14

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 14

Practitioners 4

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

Affiliated clinicians 660

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 660

Care Compare: Home health agency

Medicare Care Compare
Listed as
Penn Medicine Home HealthCCN 397125
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Apr 26, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070402000058 PA Part a Provider - Home Health Agency 0042115008 Practice locations: Bala Cynwyd, PA; West Chester, PA

Home health agency certification: CCN 397125

Medicare enrollment files
Legal name
PRESBYTERIAN MEDICAL CENTER OF THE UNIVERSITY OF PENNSYLVANIA HEALTH S
Doing business as
PENN MEDICINE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 26, 1977
Last certification
Aug 8, 2013
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Jun 13, 1995 in PA
Enrollment address
150 Monument Rd
Ste 600
Bala Cynwyd, PA 19004-1701
HHA Branch

All disclosed owners & managing parties 14

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Julia Puchtler Individual Corporate Officer Jul 1, 2024
Corporate DirectorBoard Member Jul 1, 2024
Gene Gofman Individual Corporate OfficerCfo May 26, 2023
Trustees of the University of Pennsylvania Organization, Philadelphia, PA Non-profit 5% Or Greater Direct Ownership Interest Jun 13, 1995 100%
Michele Volpe Individual Corporate Director Mar 1, 1999
W-2 Managing Employee Mar 1, 1999
Kevin B Mahoney Individual Corporate DirectorDirector Jun 6, 2019
Benjamin Chih-an Sun Individual Corporate DirectorBoard Member May 4, 2023
Nicole Hoke Individual Corporate DirectorBoard Member Sep 11, 2024
Renee Cardwell Hughes Individual Corporate DirectorBoard Member Sep 15, 2022
Sandra G Jost Individual Corporate DirectorAssociate Executive Director, CH Mar 5, 2012
W-2 Managing EmployeeAssociate Executive Director, CH Mar 5, 2012
Ann Conlin Individual Corporate Director Jun 15, 2011
Steve Shihadeh Individual Corporate DirectorBoard Member Jun 4, 2024
Michael Rossi Individual W-2 Managing Employee Jul 1, 2017
Jack Ende Individual Corporate Director Nov 6, 2000
Robert Russell Individual Corporate DirectorBoard Member Sep 1, 2022

All facility ownership & control disclosures 1

Medicare enrollment files

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

FacilityTypeRoleSince
Penn Presbyterian Medical CenterPhiladelphia, PA, CCN 390223 Hospital Operational/Managerial Control Jun 13, 1995

National Provider Directory

National Provider Directory

Locations

150 Monument Rd
Ste 600
Bala Cynwyd, PA 19004
Phone (610) 617-2400

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 712505 PA Primary

Addresses

NPPES NPI Registry

Primary practice location

150 Monument Rd
Suite 300
Bala Cynwyd, PA 19004-1725

Mailing address

150 Monument Rd
Suite 300
Bala Cynwyd, PA 19004-1725
Phone (610) 747-3400

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1007297070016MedicaidPA

Other names 1

NPPES NPI Registry
  • PENN CARE AT HOME Doing business as

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 7, 2023.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680825600000",
    "number": "1992746366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD",
            "address_2": "SUITE 300",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041725",
            "telephone_number": "610-747-3400",
            "fax_number": "610-747-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD",
            "address_2": "SUITE 300",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041725",
            "telephone_number": "610-747-3400",
            "fax_number": "610-747-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN MEDICAL CENTER OF THE UNIVERSITY OF PENNSYLVANIA HEALTH S",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A",
        "authorized_official_last_name": "WEINSTEIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO PENN HOME CARE & HOSPICE",
        "authorized_official_telephone_number": "610-747-3400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "712505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007297070016",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PENN CARE AT HOME",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PENN CARE AT HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bala Cynwyd, PA

Sources for this page

Verify at the official NPI Registry.