Provider Type Icon

UNIVERSITY OF PENN - MEDICAL GROUP NPI 1497767495


NPI Information

NPI: 1497767495
Provider Name: UNIVERSITY OF PENN - MEDICAL GROUP
Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
3615 CHESTNUT ST
RALSTON-PENN CENTER
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 662-2746
Get Directions

UNIVERSITY OF PENN - MEDICAL GROUP is a geriatric medicine internal medicine in Philadelphia, PA. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. UNIVERSITY OF PENN - MEDICAL GROUP NPI is 1497767495. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3615 CHESTNUT ST
RALSTON-PENN CENTER
PHILADELPHIA, PA
ZIP 19104-612
Phone: (215) 662-2746
Fax: (215) 349-5648

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 8/12/2006 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
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineNo
3207RG0300XInternal MedicineGeriatric MedicineYes
4207RP1001XInternal MedicinePulmonary DiseaseNo

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
1496703OTHERPENNSYLVANIAAETNA
2043052OTHERPENNSYLVANIABLUE SHIELD
35466407OTHERNEW JERSEYNJ-MEDICAID
4G0005268OTHERPENNSYLVANIAAMERICHOICE
50006610360MEDICAIDPENNSYLVANIA
60270301000OTHERPENNSYLVANIAKEYSTONE
70002Y20116OTHERPENNSYLVANIAHEALTHNET
81010530OTHERPENNSYLVANIAMERCY
9273211OTHERPENNSYLVANIAMAMSI
1011192OTHERPENNSYLVANIAHEALTH PARTNERS
11CA0235OTHERPENNSYLVANIARR 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.