COATESVILLE CLINIC COMPANY LLC (NPI# 1629009642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629009642 |
| Entity Type | Organization |
| Organization Name | COATESVILLE CLINIC COMPANY LLC |
| Other Organization Name | NEUROLOGY COATESVILLE SUITE 22A TOWER HEALTH MEDICAL GROUP |
| Practice Address |
213 Reeceville Rd Ste 23 Coatesville PA 19320-1528 |
| Mailing Address |
Po Box 13579 Reading PA 19612-3579 |
| Practice Telephone | 6103846550 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-08-10 |
| Authorized Official Name | LUIS ROSA (VP PAYOR CONTRACTING) |
| Authorized Official Telephone | 4846288181 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | PA | Allopathic & Osteopathic Physicians | |
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1015851470002 | 05 | |
| PA | 1015851470003 | 05 | |
| PA | 1015851470010 | 05 | |
| PA | BCBS | 1872587 | 01 |
| PA | 1015851470009 | 05 | |
| PA | BCBS | 1848182 | 01 |
| PA | BCBS | 1846059 | 01 |
| PA | 1015851470007 | 05 |
| Other Name | Type Code |
|---|---|
| Family Medicine Downington Tower Health Medical Group | Doing Business As Name - Organization |
| Family Medicine Exton Thomas Jones Tower Health Medical Group | Doing Business As Name - Organization |
| Family Medicine Exton Uwchlan Ave Tower Health Medical Group | Doing Business As Name - Organization |
| Neurology Coatesville Suite 22 Tower Health Medical Group | Doing Business As Name - Organization |
| Neurology Coatesville Suite 22A Tower Health Medical Group | Former Legal Business Name - Organization |
| Neurology West Grove Vineyard Way Tower Health Medical Group | Doing Business As Name - Organization |
| Psychiatry Coatesville Tower Health Medical Group | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 495 Thomas Jones Way Ste 100, Exton, PA 193412553 | 6105244106 | |
| 119 E Uwchlan Ave Ste 200, Exton, PA 193411293 | 6105943512 | |
| 213 Reeceville Rd Ste 22a, Coatesville, PA 193201529 | 6103847491 | |
| 219 Reeceville Rd Fl 2, Coatesville, PA 193201546 | 6103838470 | |
| 390 Vineyard Way Bldg 201, West Grove, PA 193908835 | 6103847491 | |
| 625 N Pottstown Pike, Exton, PA 193411628 | 6109030640 | |
| 77 Manor Ave Ste 100, Downingtown, PA 193352661 | 6102699570 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720628407 | Coatesville Clinic Company LLC | Internal Medicine | 201 Reeceville Rd, Coatesville, PA 19320-1542 | 2020-01-10 |
| Street Address |
213 REECEVILLE RD STE 23 |
| City | COATESVILLE |
| State | PA |
| Zip Code | 19320-1528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538164579 | Raida Rabah | Internal Medicine | 213 Reeceville Rd, Ste 27, Coatesville, PA 19320-1528 | 2005-06-16 |
| 1619228376 | Kalyca Leyana Dubose | Nurse Practitioner | 213 Reeceville Rd, Suite 27, Coatesville, PA 19320-1528 | 2012-09-21 |
| 1710269766 | Debra T Wright | Nurse Practitioner | 213 Reeceville Rd, Suite 17, Coatesville, PA 19320-1528 | 2011-09-15 |
| 1477708345 | Michael Urbano M D | Internal Medicine | 213 Reeceville Rd, Suite 32, Coatesville, PA 19320-1528 | 2008-11-19 |
| 1467625541 | Heidar K. Jahromi, M.d. P.C. | Psychiatry & Neurology | 213 Reeceville Rd, Suite 22, Coatesville, PA 19320-1528 | 2008-04-09 |
| 1679751754 | Brandywine Valley Neurosurgery and Spine LLC | Neurological Surgery | 213 Reeceville Rd, Ste 33, Coatesville, PA 19320-1528 | 2008-01-31 |
| 1760670947 | Martha L Harpham | Nurse Practitioner | 213 Reeceville Rd, Ste 36, Coatesville, PA 19320-1528 | 2007-10-12 |
| 1669681110 | Jose R Monasterio | General Practice | 213 Reeceville Rd, Suite 10, Coatesville, PA 19320-1574 | 2007-05-22 |
| 1952516445 | Susan Jennifer Sees | Surgery | 213 Reeceville Rd, Suite 23, Coatesville, PA 19320-1528 | 2007-05-10 |
| 1336277516 | John H Bartels | Internal Medicine | 213 Reeceville Rd, Suite 12, Coatesville, PA 19320-1528 | 2007-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962029306 | Ara Dadivanyan | Psychiatry & Neurology | 201 Reeceville Rd., Brandywine Hospital, Coatesville, PA 19320 | 2020-07-01 |
| 1669098919 | Sara Mostafa | Psychiatry & Neurology | Brandy Wine Hospital, 201 Reeceville Rd, Coatesville, PA 19320 | 2020-06-23 |
| 1225654072 | Laurie Bond | Counselor | 774 East Lincoln Highway, Coatesville, PA 19320 | 2020-06-17 |
| 1356964506 | Timothy Robert Derosa | Psychiatry & Neurology | Brandywine Hospital 201 Reeceville Rd., Coatesville, Pa, PA 19320 | 2020-05-22 |
| 1184264632 | Evolve Individual Services, LLC | Counselor | 135 E Chestnut St, 204, Coatesville, PA 19320 | 2020-01-13 |
| 1649824111 | Angela Lynne Sylvina | Social Worker | 1825 E Lincoln Highway, Coatesville, PA 19320 | 2019-08-01 |
| 1629540257 | Rhonda Jean Sanford | Social Worker | Coatesville Vamc, Attn: Rhonda Sanford, Lcsw, 1400 Blackhorse Hill Rd, Bldg 57, Rm 227, Coatesvillle, PA 19320 | 2018-12-20 |
| 1528540499 | Jetquatta Parker | Licensed Practical Nurse | 786 Coates St, Coatesville, PA 19320 | 2018-09-06 |
| 1639608052 | Shafkat Hussain | Pharmacist | 800 East Lincoln Highway, Coatesville, PA 19320 | 2017-06-08 |
| 1790222032 | Elizabeth Barnett | Counselor | 2034crest Dr, Coatesville, PA 19320 | 2017-01-25 |
| Find all providers in zip 19320 | ||||
| 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 |
|---|---|---|---|---|
| 1871821090 | Benjamin Christian Bullock | Internal Medicine | 305 Revere Ct, Coatesville, PA 19320-5923 | 2009-11-29 |
| 1811906142 | Alexander J. Klufas | Internal Medicine | 423 E Chestnut St, Coatesville, PA 19320 | 2006-08-05 |
| 1104800770 | Lisette Triana Cooper | Internal Medicine | 1400 Black Horse Hill Road, Va Medical Center Building 2, Coatesville, PA 19320-2096 | 2005-12-06 |
| 1477708345 | Michael Urbano M D | Internal Medicine | 213 Reeceville Rd, Suite 32, Coatesville, PA 19320-1528 | 2008-11-19 |
| 1538358767 | Kirti Tandon Molinari | Internal Medicine | 1400 Blackhorse Hill Rd, Coatesville, PA 19320-2040 | 2007-10-24 |
| 1093917023 | Vijaya Chada | Internal Medicine | 201 Reeceville Rd, Coatesville, PA 19320-1542 | 2007-06-01 |
| 1669549176 | Gateway Internal Medicine At Brandywine | Internal Medicine | 217 Reeceville Rd, Suite C, Coatesville, PA 19320-1546 | 2006-11-29 |
| 1609956135 | Ketki Dhaval Mehta | Internal Medicine | 1400 Blackhorse Hill Rd, Coatesville, PA 19320-2040 | 2006-10-17 |
| 1083622880 | Susheil K. Gomer | Internal Medicine | 1400 Blackhorse Hill Rd, Coatesville, PA 19320-2040 | 2006-08-04 |
| 1164438735 | Tanveer J. Qureshi | Internal Medicine | 1400 Blackhorse Hill Rd, Coatesville, PA 19320-2040 | 2006-08-01 |
| Find all providers in COATESVILLE | ||||
| City | COATESVILLE |
| Zip Code | 19320 |
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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.