UNIVERSITY OF PENN - MEDICAL GROUP NPI 1093725145

NPI Information

NPI: 1093725145
Provider Name: UNIVERSITY OF PENN - MEDICAL GROUP
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
3400 CIVIC CENTER BLVD
EAST PAVILION, 2ND FLOOR
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 615-4949
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UNIVERSITY OF PENN - MEDICAL GROUP is a cardiovascular disease internal medicine in Philadelphia, PA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. UNIVERSITY OF PENN - MEDICAL GROUP NPI is 1093725145. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3400 CIVIC CENTER BLVD
EAST PAVILION, 2ND FLOOR
PHILADELPHIA, PA
ZIP 19104-127
Phone: (215) 615-4949

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 8/9/2006 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 Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	PENNSYLVANIA	Yes
2	207RC0001X	Internal Medicine	Clinical Cardiac Electrophysiology	PENNSYLVANIA	No
3	207RI0011X	Internal Medicine	Interventional Cardiology	PENNSYLVANIA	No
4	207UN0901X	Nuclear Medicine	Nuclear Cardiology		No

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	10670	OTHER	PENNSYLVANIA	HEALTHPARTNERS
2	CA0235	OTHER	PENNSYLVANIA	RR MEDICARE
3	496667	OTHER	PENNSYLVANIA	AETNA
4	0006610360	MEDICAID	PENNSYLVANIA
5	027133400001	OTHER	PENNSYLVANIA	KEYSTONE
6	1003417	OTHER	PENNSYLVANIA	KEYSTONE MERCY
7	273543	OTHER	PENNSYLVANIA	MAMSI
8	5541301	OTHER	NEW JERSEY	NJ MEDICAID
9	0002Y20116	OTHER	PENNSYLVANIA	HEATHNET
10	058354	OTHER	PENNSYLVANIA	BLUE SHIELD

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

NPI Synchronization or Removal

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