CROSSOVER HEALTH MEDICAL GROUP


Address: 1701 John F Kennedy Blvd Fl 25, Philadelphia, PA 19103-2851
Phone: 9498910328

CROSSOVER HEALTH MEDICAL GROUP (NPI# 1629638481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629638481
Entity Type Organization
Organization Name CROSSOVER HEALTH MEDICAL GROUP
Other Organization Name CROSSOVER HEALTH
Practice Address 1701 John F Kennedy Blvd Fl 25
Philadelphia
PA 19103-2851
Practice Telephone 9498910328
Mailing Telephone 9498910328
Enumeration Date 2019-06-14
Last Update Date 2019-08-15
Authorized Official Name ANGIE SAKIOKA (HR OPERATIONS SPECIALIST)
Authorized Official Telephone 9498910328
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Crossover Health Doing Business As Name - Organization

Provider Secondary Practice Location

Address Telephone Number Fax Number
1 Comcast Ctr, 1701 John F Kennedy Boulevard, Philadelphia, PA 19103 9498910328
1701 John F Kennedy Blvd Fl 25, Philadelphia, PA 191032851 9498910328

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1205443751 Crossover Health Medical Group Clinic/Center 424 E. 4th St, Suite 100, Royal Oak, MI 48067 2020-09-29
1184231037 Crossover Health Medical Group Clinic/Center 434 Patrol Rd, Jeffersonville, IN 47130-7754 2020-09-24
1982211835 Crossover Health Medical Group Clinic/Center 711 W 2nd St Ste A, San Bernardino, CA 92410-3262 2020-09-24
1619584570 Crossover Health Medical Group Clinic/Center 19901 Dix Toledo Hwy, Brownstown Twp, MI 48183-1039 2020-09-24
1982211843 Crossover Health Medical Group Clinic/Center 5379 Hamner Ave Unit 801, Eastvale, CA 91752-1042 2020-09-24
1992312847 Crossover Health Medical Group Clinic/Center 544 Conestoga Pkwy Ste 3, Shepherdsville, KY 40165-5676 2020-09-24
1639786585 Crossover Health Medical Group Clinic/Center 1847 E Southern Ave Ste 3, Tempe, AZ 85282-5881 2020-09-24
1164039020 Crossover Health Medical Group Clinic/Center 14329 Frederick St Ste 7-9, Moreno Valley, CA 92553-9003 2020-09-24
1821605775 Crossover Health Medical Group Clinic/Center 5251 W Campbell Ave Ste 200, Phoenix, AZ 85031-1719 2020-09-24
1649887597 Crossover Health Medical Group Clinic/Center 8343 W Van Buren St Bldg C-2, Tolleson, AZ 85353-3225 2020-09-24

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations CROSSOVER HEALTH MEDICAL GROUP, APC 101 W Avenida Vista Hermosa, San Clemente, CA 92672-7706
New York State Corporations CROSSOVER HEALTH MEDICAL GROUP, APC 99 Washington Avenue, Suite 1008, Albany, New York 12260
Massachusetts Corporations CROSSOVER HEALTH MEDICAL GROUP, APC 65 Enterprise, Alisa Viejo, CA 92656
Colorado Business Entities CROSSOVER HEALTH MEDICAL GROUP, APC 101 West Avenida Vista Hermosa, Suite 120, San Clemente, CA 92672

Office Location

Street Address 1701 JOHN F KENNEDY BLVD FL 25
City PHILADELPHIA
State PA
Zip Code 19103-2851

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NPI Name Taxonomy Address Enumeration
1518565431 Allyson Caputa Behavior Technician 100 North 18th Street, Suite 300, Philadelphia, PA 19103 2020-10-13
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1932761863 Barclay Prescription Pharmacy Pharmacist 1736 Spruce St, Phila, PA 19103 2019-07-01
1265910459 Whitney Sue Fricke Counselor 2211 Locust St, Philadelphia, PA 19103 2018-07-31
1740784586 Sara Elizabeth Macintyre Speech-Language Pathologist 1845 Walnut Street Suite 1540, Philadelphia, PA 19103 2018-03-19
1326578907 Danielle D Bercovitch Speech-Language Pathologist 1930 S Broad, Philadelphia, PA 19103 2017-06-15
1598114449 Brooke Elaine Mullen Dietitian, Registered 1708 Pine St Apt 1r, Philadelphia, PA 19103 2016-06-10
1972966026 Alexandra Brady Jatzke Dietitian, Registered 1835 Market St Fl 2, Philadelphia, PA 19103 2016-04-05
1932574118 David Clements Iv Psychiatry & Neurology 1845 Walnut St Ste 1540, Philadelphia, PA 19103 2015-12-14
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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

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Competitor

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City PHILADELPHIA
Zip Code 19103

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Dataset Information

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.

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