UNIVERSITY OF PENN - MEDICAL GROUP (NPI# 1720553001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720553001 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF PENN - MEDICAL GROUP |
| Practice Address |
4923 Stanton Ogletown Rd Newark DE 19713-2081 |
| Mailing Address |
Po Box 824320 Philadelphia PA 19182-4320 |
| Practice Telephone | 2156626200 |
| Practice Fax Number | 2156622244 |
| Mailing Telephone | 2156626187 |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2018-10-12 |
| Authorized Official Name | CHANTE L JACKSON (ENROLLMENT COOR) |
| Authorized Official Telephone | 2156626187 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| Y | 204F00000X | Transplant Surgery | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1477660173 | University of Penn - Medical Group | Internal Medicine | 3400 Spruce St, 3 Dulles Building, 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 |
4923 STANTON OGLETOWN RD |
| City | NEWARK |
| State | DE |
| Zip Code | 19713-2081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574490 | Stacie Guyton | Nurse Practitioner | 4501 Ogletown Stanton Road, Newark, DE 19713 | 2020-09-25 |
| 1225674633 | Michael Francis Stant | Specialist/Technologist | Delaware Field House, 617 South College Avenue Rm 111b, Newark, DE 19713 | 2019-11-20 |
| 1528559457 | Sarah Mun | Physician Assistant | 4755 Ogletown Stanton Rd, Newark, DE 19713 | 2018-05-26 |
| 1568983286 | Clarice Wanisku Kariuki | Licensed Practical Nurse | 15 Prestbury Square, Suite 14, Nweark, DE 19713 | 2017-07-03 |
| 1679029870 | Auxilia Akala | Nurse Practitioner | 1082 Churchmans Rd, Newrk, DE 19713 | 2016-08-28 |
| 1003369851 | Yawar Abbas | Psychiatry & Neurology | Rockford Center, 100 Rockford Dr, Newark, DE 19713 | 2016-07-28 |
| 1700245925 | Debra Hutz | Counselor | 25 Omega Dr., Professional Center #j, Newark, DE 19713 | 2016-02-16 |
| 1376918201 | Aquiles Igleisias | Speech-Language Pathologist | 540 South College Avenue, Newark, DE 19713 | 2015-12-03 |
| 1639547359 | Kylee Rose | Social Worker | 901 S. Chapel Street, Newark, DE 19713 | 2015-09-11 |
| 1932503976 | Kathleen Madara | Physical Therapist | 540 S College Ave, Suite 210, University of Delaware, Newark, DE 19713 | 2014-10-20 |
| Find all providers in zip 19713 | ||||
| Taxonomy Code | 204F00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Transplant Surgery |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295971430 | Diego C Reino | Transplant Surgery | 185 S Orange Ave # Msbg-506, Newark, NJ 07103-2757 | 2008-12-17 |
| 1407021132 | Keri Elizabeth Lunsford | Transplant Surgery | 140 Bergen St # E1650, Newark, NJ 07103 | 2008-04-23 |
| 1417998782 | James Vincent Guarrera | Transplant Surgery | 140 Bergen St # E1620, Newark, NJ 07103 | 2006-06-09 |
| 1003462854 | University Surgical Associates (om) | Transplant Surgery | 90 Bergen St, Newark, NJ 07103-2425 | 2019-08-16 |
| 1760666507 | Flavio Paterno | Transplant Surgery | 140 Bergen St, Newark, NJ 07103-2425 | 2007-12-27 |
| 1114136645 | Lloyd Garth Brown | Transplant Surgery | 185 S Orange Ave, Msb, Room G-594, Newark, NJ 07103-2757 | 2007-05-22 |
| 1437161874 | Subhashini Manjula Ayloo | Transplant Surgery | 140 Bergen Street, Acc Bldg D-1650, Newark, NJ 07103 | 2006-08-13 |
| 1912925157 | Adrian A. Fisher | Transplant Surgery | 90 Bergen St, Doc 7100, Newark, NJ 07103-2425 | 2006-07-17 |
| 1700811494 | Dorian J. Wilson | Transplant Surgery | 30 Bergen St, Admc 12 1205, Newark, NJ 07107-3000 | 2006-07-11 |
| 1588694558 | Baburao Koneru | Transplant Surgery | 90 Bergen St, Doc 7100, Newark, NJ 07103-2425 | 2006-07-04 |
| Find all providers in NEWARK | ||||
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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.