UNIVERSITY OF PENN-MEDICAL GROUP (NPI# 1518355627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518355627 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF PENN-MEDICAL GROUP |
| Practice Address |
3400 Spruce St 8 Ravdin Philadelphia PA 19104-4238 |
| Practice Telephone | 2156623228 |
| Mailing Telephone | 2156623228 |
| Enumeration Date | 2014-12-26 |
| Last Update Date | 2014-12-26 |
| 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 |
|---|---|---|---|---|---|
| N | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
PA | Allopathic & Osteopathic Physicians | |
| N | 208000000X | Pediatrics | PA | Allopathic & Osteopathic Physicians | |
| N | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
PA | Allopathic & Osteopathic Physicians | |
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396193900 | University of Penn-medical Group | Transplant Surgery | 1501 N Cedar Crest Blvd, Suite 110 Liver Transplant, Allentown, PA 18104-2309 | 2016-05-25 |
| 1821451139 | University of Penn-medical Group | Internal Medicine | 554 N Duke St, 3rd Floor Renal Transplant, Lancaster, PA 17602-2225 | 2016-04-04 |
| 1902269210 | University of Penn-medical Group | Surgery | 554 N Duke St, 3rd Floor, Lancaster, PA 17602-2225 | 2016-04-04 |
| 1043670805 | University of Penn-medical Group | Internal Medicine | 554 N Duke St, 3rd Floor Gi Transplant, Lancaster, PA 17602-2225 | 2016-03-07 |
| 1730578667 | University of Penn-medical Group | Internal Medicine | 3400 Spruce St, Ground Floor Donner, Philadelphia, PA 19104-4238 | 2015-01-15 |
| 1073902169 | University of Penn-medical Group | Dermatology | 3400 Spruce St, 2 Rhoads Pavilion, Philadelphia, PA 19104-4238 | 2015-01-13 |
| 1184012569 | University of Penn-medical Group | Clinical Medical Laboratory | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2015-01-07 |
| 1821486846 | University of Penn-medical Group | Marriage & Family Therapist | 3535 Market St, 3rd Floor, Philadelphia, PA 19104-3309 | 2014-12-29 |
| 1740678762 | University of Penn-medical Group | Pathology | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2014-12-29 |
| 1811385834 | University of Penn-medical Group | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 51 N 39th St, 266 Wright Saunders, Philadelphia, PA 19104-2640 | 2014-12-29 |
| Street Address |
3400 SPRUCE ST 8 RAVDIN |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-4238 |
| 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 | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568656981 | Mario Zichella Jr. | Pediatrics | 1025 Walnut Street, Suite 700, Philadelphia, PA 19107-3121 | 2007-08-29 |
| 1235333774 | Andrea Freeman Duncan | Pediatrics | 3401 Civic Center Blvd Fl 2, Philadelphia, PA 19104-4319 | 2007-06-11 |
| 1831302603 | Folasade Ibironke Kehinde | Pediatrics | 160 E Erie Ave Dept Of, Philadelphia, PA 19134-1011 | 2007-05-08 |
| 1639204225 | Kirstie R Marcello | Pediatrics | 111 South 11th Street, 7th Floor College Building, Philadelphia, PA 19107 | 2007-02-22 |
| 1134286677 | Yanick Mary Vibert | Pediatrics | 230 North Broad Street, Mailstop 492, 10th Floor South Tower Neonatology Office, Philadelphia, PA 19102 | 2007-01-03 |
| 1164476842 | Karen Fritz | Pediatrics | St. Christopher's Hospital Erie Ave and Front St, Div of Neonatology, Philadelphia, PA 19131 | 2006-05-19 |
| 1043274376 | Daniel Henry Conway | Pediatrics | Front St and Erie Ave, St. Christopher's Hospital for Children, Philadelphia, PA 19134 | 2006-04-13 |
| 1720623200 | Stc Pediatrics LLC | Pediatrics | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2019-11-08 |
| 1639713076 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-10-29 |
| 1750863619 | Temple Faculty Practice Plan, Inc | Pediatrics | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2018-09-06 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on UNIVERSITY OF PENN-MEDICAL GROUP.
| 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.