UNIVERSITY OF PENN - MEDICAL GROUP (NPI# 1477660173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477660173 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF PENN - MEDICAL GROUP |
| Practice Address |
3400 Spruce St 3 Dulles Building Philadelphia PA 19104-4206 |
| Mailing Address |
3400 Spruce St 3 Dulles Philadelphia PA 19104-4206 |
| Practice Telephone | 2153498222 |
| Mailing Telephone | 2153498222 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2009-04-15 |
| Authorized Official Name | ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2156627583 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HEALTHNET | 0002Y20116 | 01 |
| PA | BLUE SHIELD | 063598 | 01 |
| PA | MAMSI | 273194 | 01 |
| PA | RR MEDICARE | CA0235 | 01 |
| PA | KEYSTONE | 0322705000 | 01 |
| PA | MERCY | 1010509 | 01 |
| PA | 0006610360 | 05 | |
| PA | HEALTHPARTNERS | 10706 | 01 |
| PA | AETNA | 496672 | 01 |
| NJ | NJ-MEDICAID | 5465605 | 01 |
| PA | AMERICHOICE | G0003165 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720553001 | University of Penn - Medical Group | Internal Medicine | 4923 Stanton Ogletown Rd, Newark, DE 19713-2081 | 2018-10-12 |
| 1114481504 | University of Penn - Medical Group | Clinic/Center | 1800 Lombard St Ste 206, Philadelphia, PA 19146-1414 | 2019-01-30 |
| 1053447151 | University of Penn - Medical Group | Internal Medicine | 3400 Spruce St, Philadelphia, PA 19104-4206 | 2007-02-26 |
| 1194829739 | University of Penn - Medical Group | Psychologist | 3400 Spruce St, 11 Gates, Philadelphia, PA 19104-4206 | 2006-09-12 |
| 1659488351 | University of Penn - Medical Group | Allergy & Immunology | 3737 Market St, 3rd Floor, Philadelphia, PA 19104-5545 | 2006-08-25 |
| 1568579266 | University of Penn - Medical Group | Internal Medicine | 3400 Spruce St, 1 Maloney, Philadelphia, PA 19104-4206 | 2006-08-25 |
| 1003923707 | University of Penn - Medical Group | Internal Medicine | 3400 Spruce St, 3 Ravdin, Suite F, Pulmonary & Critical Care, Philadelphia, PA 19104-4206 | 2006-08-25 |
| 1912014614 | University of Penn - Medical Group | Internal Medicine | 3400 Spruce St, One Maloney, Philadelphia, PA 19104-4206 | 2006-08-25 |
| 1629181912 | University of Penn - Medical Group | Internal Medicine | 3400 Spruce St, 210 White Building, Philadelphia, PA 19104-4206 | 2006-08-17 |
| 1497767495 | University of Penn - Medical Group | Internal Medicine | 3615 Chestnut St, Ralston-penn Center, Philadelphia, PA 19104-2612 | 2006-08-12 |
| Street Address |
3400 SPRUCE ST 3 DULLES BUILDING |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-4206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063415966 | Samuel Isaiah Parry | Obstetrics & Gynecology | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2005-05-24 |
| 1831790609 | Renate Marie Balitzky | Registered Nurse | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-11-06 |
| 1053911156 | Jordan Charles Templeton | Physician Assistant | 3400 Spruce St, Philadelphia, PA 19104-4274 | 2020-10-28 |
| 1992305304 | Alyssa N Volpe | Registered Nurse | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-10-27 |
| 1700486115 | Christina Haddow | Registered Nurse | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-10-27 |
| 1629677497 | Marissa Leigh Berlant | Physician Assistant | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-10-22 |
| 1811595523 | Kristen Gilgen | Anesthesiology | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-10-14 |
| 1962014654 | Stacey Pham | Nurse Practitioner | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-08-23 |
| 1265040109 | Abdullah T Almuqate | Pathology | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-07-16 |
| 1952928541 | Stefen Andrianus | Student in an Organized Health Care Education/Training Program | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal 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 |
|---|---|---|---|---|
| 1013150796 | Richard Mao Wu | Internal Medicine | 132 S. 10th Street, Main Bldg, Ste 430, Philadelphia, PA 19107 | 2009-04-11 |
| 1811148430 | Kian Makipour | Internal Medicine | 3401 North Broad St, Philadelphia, PA 19130 | 2008-10-01 |
| 1982865127 | Shivan Jatin Mehta | Internal Medicine | 423 Guardian Dr, Blockley Hall 1137, Philadelphia, PA 19104-4865 | 2008-06-20 |
| 1730204355 | Rahul Anand Nathwani | Internal Medicine | 132 S 10th St Ste 480, Philadelphia, PA 19107-5244 | 2007-03-20 |
| 1386729705 | Blake Gastroenterology Associates, LLC | Internal Medicine | 6827-31 Germantown Ave, Philadelphia, PA 19119-2113 | 2006-10-25 |
| 1942393830 | John Patrick Lynch | Internal Medicine | 415 Curie Blvd, 600 Crb, Philadelphia, PA 19104-4306 | 2006-10-02 |
| 1962428433 | Keith Joseph Buhl | Internal Medicine | 1403 Rhawn Street, Philadelphia, PA 19111-2430 | 2006-07-15 |
| 1366476020 | Michael J Rosner | Internal Medicine | 4242 Cottman Ave, Philadelphia, PA 19135-1118 | 2006-07-10 |
| 1558300152 | Xiaoli Ma | Internal Medicine | 121 N 9th St, Philadelphia, PA 19107-2410 | 2006-06-06 |
| 1275571945 | Oleg Volchonok | Internal Medicine | 11400 Bustleton Ave, Philadelphia, PA 19116-2815 | 2006-06-03 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
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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.