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UNIVERSITY OF PENN - MEDICAL GROUP NPI 1003923707


NPI Information

NPI: 1003923707
Provider Name: UNIVERSITY OF PENN - MEDICAL GROUP
Classification: Internal Medicine - 207RP1001X
Entity Type: Organization

Specialization: Pulmonary Disease

Address:
3400 SPRUCE ST
3 RAVDIN, SUITE F, PULMONARY & CRITICAL CARE
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 662-3202
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UNIVERSITY OF PENN - MEDICAL GROUP is a pulmonary disease internal medicine in Philadelphia, PA. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. UNIVERSITY OF PENN - MEDICAL GROUP NPI is 1003923707. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3400 SPRUCE ST
3 RAVDIN, SUITE F, PULMONARY & CRITICAL CARE
PHILADELPHIA, PA
ZIP 19104-206
Phone: (215) 662-3202

The provider's authorized official is Chante L Jackson .
The authorized official title is Enrollment Lead and has the following contact phone number (215) 662-6187.

The enumeration date for this NPI number is 8/25/2006 and was last updated on 11/19/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineNo
2207RC0200XInternal MedicineCritical Care MedicineNo
3207RP1001XInternal MedicinePulmonary DiseaseYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G00031670OTHERPENNSYLVANIAAMERICHOICE
20006610360MEDICAIDPENNSYLVANIA
30193436000OTHERPENNSYLVANIAKEYSTONE
4273248OTHERPENNSYLVANIAMAMSI
5043063OTHERPENNSYLVANIABLUE SHIELD
6020255499OTHERPENNSYLVANIAEEIOC
706632OTHERPENNSYLVANIAHEALTHPARTNERS
81010943OTHERPENNSYLVANIAMERCY
9495710OTHERPENNSYLVANIAAETNA
10002Y20116OTHERPENNSYLVANIAHEALTHNET
115469406OTHERNEW JERSEYNJ-MEDICAID
12CA0235OTHERPENNSYLVANIARR MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.