POPLAR MEDICAL GROUP,LLC (NPI# 1104470764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104470764 |
| Entity Type | Organization |
| Organization Name | POPLAR MEDICAL GROUP,LLC |
| Practice Address |
2100 W Girard Ave Philadelphia PA 19130-1400 |
| Mailing Address |
Po Box 687 Jenkintown PA 19046-3706 |
| Practice Telephone | 2156850800 |
| Practice Fax Number | 2156850846 |
| Mailing Telephone | 2156714280 |
| Mailing Fax Number | 2154649034 |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2019-07-31 |
| Authorized Official Name | DENNIS ENEANYA (PRESIDENT) |
| Authorized Official Telephone | 2156714280 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
2100 W GIRARD AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19130-1400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811980030 | Theodore Burden | Internal Medicine | 2100 W Girard Ave, Philadelphia, PA 19130-1400 | 2005-08-23 |
| 1700266269 | 2157627000 | Skilled Nursing Facility | 2100 W Girard Ave, Philadelphia, PA 19130-1400 | 2015-05-31 |
| 1194157842 | Hps of Pa LLC | Internal Medicine | 2100 W Girard Ave, Philadelphia, PA 19130-1400 | 2013-08-05 |
| 1336412154 | Michael Robert Pechinka | Occupational Therapist | 2100 W Girard Ave, Philadelphia, PA 19130-1400 | 2012-02-10 |
| 1437388428 | Clisdel Marie Torrico Miranda | Physical Therapist | 2100 W Girard Ave, Philadelphia, PA 19130-1400 | 2009-07-10 |
| 1154564623 | Walidah E West | Physical Therapist | 2100 W Girard Ave, Philadelphia, PA 19130-1400 | 2009-04-14 |
| 1043493901 | Henrietta D Mtshali | Physician Assistant | 2100 W Girard Ave, Philadelphia, PA 19130-1400 | 2007-12-13 |
| 1487841961 | The Philadelphia Nursing Home | Skilled Nursing Facility | 2100 W Girard Ave, The Philadelphia Nursing Home, Philadelphia, PA 19130 | 2007-09-28 |
| 1902024201 | Charles David Munson Jr. | Physical Therapist | 2100 W Girard Ave, Philadelphia, PA 19130-1400 | 2007-04-23 |
| 1467679795 | Patricia M Scapellati | Speech-Language Pathologist | 2100 W Girard Ave, Philadelphia, PA 19130 | 2007-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912518226 | Karen Dybner-madero | Psychologist | 2201 Pennsylvania Avenue, The Parkway House, Suite 101, Philadelphia, PA 19130 | 2020-08-11 |
| 1689213456 | Nora Marie Corbett | Physical Therapist | 1714 Fairmount Avenue, Philadelphia, PA 19130 | 2019-12-27 |
| 1104470665 | Thibault Counseling LLC | Clinic/Center | 2049 North Street, Philadelphia, PA 19130 | 2019-08-01 |
| 1619444577 | Rebecca Boova | Dietitian, Registered | 1644 Francis St, #3, Philadelphia, PA 19130 | 2018-10-30 |
| 1184191108 | Sharon Marie Thompson | Nurse Practitioner | School District of Philadelphia/school Health Services, 440 North Broad Street, Philadelphia, PA 19130 | 2018-10-29 |
| 1861918542 | Theresa Mary Thompson | Dental Hygienist | Delaware Valley Community Health, 1412 Fairmount Avenue, Philadelphia, PA 19130 | 2017-08-15 |
| 1023539806 | Marina France | Social Worker | 2401 Pennsylvania Ave Ste 1a2, Philadelphia, PA 19130 | 2017-06-30 |
| 1619425063 | Sarah Nash | Dietitian, Registered | 420 North 20th Street, Philadelphia, PA 19130 | 2016-09-14 |
| 1154737757 | Julia Ferrence | Social Worker | 2305 Fairmount Avenue, Philadelphia, PA 19130 | 2014-07-03 |
| 1811319924 | Larry H Goldberg | Internal Medicine | 2441 Olive Street, Philadelphia, PA 19130 | 2014-01-08 |
| Find all providers in zip 19130 | ||||
| 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 |
|---|---|---|---|---|
| 1427674407 | Jun Song | Internal Medicine | 3401 N Broad St Ste 801, Philadelphia, PA 19140-5103 | 2020-06-24 |
| 1932725264 | Aaron Leo Yazdian | Internal Medicine | 1335 South St Apt A, Philadelphia, PA 19147-1841 | 2020-06-23 |
| 1144846387 | Rishabh Khatri | Internal Medicine | 322 N Broad St Apt 1523, Philadelphia, PA 19102-1122 | 2020-06-23 |
| 1215564521 | Insight Home Physicians, PC | Internal Medicine | 7806 Cresheim Rd, Philadelphia, PA 19118-4003 | 2020-03-25 |
| 1457995938 | Tower Drexel Academic Medical Group LLC | Internal Medicine | 3401 Market St Ste 105b, Philadelphia, PA 19104-3315 | 2019-10-29 |
| 1205479904 | Tower Drexel Academic Medical Group LLC | Internal Medicine | 219 N Broad St 8fl, Philadelphia, PA 19107-1507 | 2019-10-25 |
| 1700439056 | Alvaro Goncalves Mendes Neto | Internal Medicine | 5501 Old York Rd # 363, Philadelphia, PA 19141-3018 | 2019-07-16 |
| 1720648223 | Ali Haydar | Internal Medicine | 245 N. 15th St, 6th Floor, Ms 42, Philadelphia, PA 19102 | 2019-06-17 |
| 1114587672 | Stephen Michael Pokrywa | Internal Medicine | Drexel University Com, Internal Medicine Residency, 245 N. 15th St., 6th Floor, Ms 427, Philadelphia, PA 19102-1178 | 2019-06-17 |
| 1124688734 | Aakash Patel | Internal Medicine | Drexel University College of Medicine-internal Medicine, 245 N. 15th St. 6th Floor, Ms 427, Philadelphia, PA 19102 | 2019-06-17 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19130 |
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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.