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UNIVERSITY OF PENN - MEDICAL GROUP NPI 1629181912


NPI Information

NPI: 1629181912
Provider Name: UNIVERSITY OF PENN - MEDICAL GROUP
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
3400 SPRUCE ST
210 WHITE BUILDING
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 662-2638
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UNIVERSITY OF PENN - MEDICAL GROUP is a nephrology internal medicine in Philadelphia, PA. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. UNIVERSITY OF PENN - MEDICAL GROUP NPI is 1629181912. 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
210 WHITE BUILDING
PHILADELPHIA, PA
ZIP 19104-206
Phone: (215) 662-2638

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 8/17/2006 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 MedicinePENNSYLVANIANo
2207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismPENNSYLVANIANo
3207RN0300XInternal MedicineNephrologyPENNSYLVANIAYes

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
10002Y20116OTHERPENNSYLVANIAHEALTHNET
20176009000OTHERPENNSYLVANIAKEYSTONE
31010964OTHERPENNSYLVANIAMERCY
45484103OTHERNEW JERSEYNJ-MEDICAID
5140770OTHERPENNSYLVANIABLUE SHIELD
6273252OTHERPENNSYLVANIAMAMSI
7CA0235OTHERPENNSYLVANIARR MEDICARE
8496714OTHERPENNSYLVANIAAETNA
90006610360MEDICAIDPENNSYLVANIA
10020255499OTHERPENNSYLVANIAEEIOC
1110791OTHERPENNSYLVANIAHEALTHPARTNERS
12G00031680OTHERPENNSYLVANIAAMERICHOICE

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.