DAVITA MEDICAL GROUP PHILADELPHIA, LLC (NPI# 1083157150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083157150 |
| Entity Type | Organization |
| Organization Name | DAVITA MEDICAL GROUP PHILADELPHIA, LLC |
| Practice Address |
2476 Swedesford Rd #150 Malvern PA 19355-1456 |
| Practice Telephone | 8449022345 |
| Mailing Telephone | 8449022345 |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2017-05-11 |
| Authorized Official Name | MICHAEL J LIPP (SHAREHOLDER) |
| Authorized Official Telephone | 8449022345 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194297127 | Davita Medical Group Philadelphia, LLC | Internal Medicine | 300 W 4th Ave Ste 260, Conshohocken, PA 19428-1607 | 2019-01-02 |
| 1841796711 | Davita Medical Group Philadelphia, LLC | Internal Medicine | 300 Four Falls Corporate Center, 300 Conshohocken State Rd., West Conshohocken, PA 19428 | 2018-04-01 |
| 1538665351 | Davita Medical Group Philadelphia, LLC | Internal Medicine | 300 Four Falls Corporate Center, 300 Conshohocken State Road, Second Floor Suite 260, West Conshohocken, PA 19428 | 2018-04-02 |
| Street Address |
2476 SWEDESFORD RD #150 |
| City | MALVERN |
| State | PA |
| Zip Code | 19355-1456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154781946 | Christine Wegmann | Nurse Practitioner | 2476 Swedesford Rd, # 150, Malvern, PA 19355-1456 | 2016-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588218044 | Novacare Outpatient Rehabilitation East, Inc. | Clinic/Center | 30 Liberty Boulevard, Suite 140, Malvern, PA 19355 | 2019-08-01 |
| 1871011122 | Mary Margaret Bischoff | Psychologist | 922 St. Andrews Dr., Malvern, PA 19355 | 2017-09-07 |
| 1114449527 | Reconstructive Orthopaedic Associates II, P.C. | Prosthetic/Orthotic Supplier | 650 Carnegie Boulevard, 2nd Floor, Malvern, PA 19355 | 2017-07-07 |
| 1285169243 | Smile Exchange of Malvern, LLC | Clinic/Center | 5 S. Morehall Rd, Suite 700b, Malvern, PA 19355 | 2017-04-27 |
| 1669849162 | Sahar Akhtar | Counselor | 288 Lancaster Ave Ste 1, Frazer, PA 19355 | 2015-08-31 |
| 1386020030 | Laura Ann Treston | Physical Therapy Assistant | 60 Malvern Ave., Malvern, PA 19355 | 2015-08-05 |
| 1003217191 | Hillary Schmid | Behavioral Analyst | 28 Clover Lane, Malvern, PA 19355 | 2014-09-09 |
| 1033528799 | James Greco | Pharmacist | 50 Three Tun Rd Ste 2, Malvern, PA 19355 | 2014-08-07 |
| 1952712085 | Rachael Joseph | Community/Behavioral Health | 45 Kelmar Avenue, Malvern, PA 19355 | 2014-05-12 |
| 1487081808 | Ronia Arabatlian | Social Worker | 1 North Bacton Rd, 107, Malvern, PA 19355 | 2013-09-30 |
| Find all providers in zip 19355 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881000651 | Vinod K. Thangada, Md, PC | Internal Medicine | 5 Frame Ave, Suite 204, Malvern, PA 19355-1520 | 2014-07-01 |
| 1881809770 | Douglas James Moeller | Internal Medicine | 5 Country View Rd, Malvern, PA 19355-1421 | 2007-05-14 |
| 1598988347 | Helise Bichefsky, Do | Internal Medicine | 32 Raffaela Drive, Malvern, PA 19355 | 2007-04-10 |
| 1952497240 | Bruce Kent Burton | Internal Medicine | 2223 Grant St, Malvern, AR 72104 | 2006-10-05 |
| 1053413724 | Ian Steven Udvarhelyi | Internal Medicine | 2185 Wyndtree Ln, Malvern, PA 19355-2343 | 2006-09-02 |
| 1770507725 | Thomas J. Nasca | Internal Medicine | 12 Allyssa Cir, Malvern, PA 19355-2891 | 2006-07-26 |
| 1275558918 | Absalom H Tilley | Internal Medicine | 1003 Schneider Dr, Malvern, AR 72104-4811 | 2006-07-13 |
| 1720054125 | Altimus Ray Bollen | Internal Medicine | 1002 Schneider Dr, Suite 104, Malvern, AR 72104-4816 | 2006-02-24 |
| 1225486319 | Katherine Streitel Borst | Internal Medicine | 414 Paoli Pike, Malvern, PA 19355-3311 | 2016-05-30 |
| 1922414994 | Jatin Kyada, Md, PC | Internal Medicine | 5 Frame Ave, Suite 204, Malvern, PA 19355-1520 | 2014-07-10 |
| Find all providers in MALVERN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.