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UNIVERSITY OF PENN-MEDICAL GROUP NPI 1679677975


NPI Information

NPI: 1679677975
Provider Name: UNIVERSITY OF PENN-MEDICAL GROUP
Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

Address:
3400 CIVIC CENTER BLVD
2ND FLOOR
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 615-5858
Get Directions

UNIVERSITY OF PENN-MEDICAL GROUP is a hematology and oncology internal medicine in Philadelphia, PA. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. UNIVERSITY OF PENN-MEDICAL GROUP NPI is 1679677975. 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
2ND FLOOR
PHILADELPHIA, PA
ZIP 19104-127
Phone: (215) 615-5858

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 9/8/2006 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
1207RH0000XInternal MedicineHematologyPENNSYLVANIANo
2207RH0003XInternal MedicineHematology & OncologyPENNSYLVANIAYes
3207RX0202XInternal MedicineMedical OncologyPENNSYLVANIANo

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
2G00031630OTHERPENNSYLVANIAAMERICHOICE
30006610360MEDICAIDPENNSYLVANIA
40351401000OTHERPENNSYLVANIAKEYSTONE
5496685OTHERPENNSYLVANIAAETNA
6CA0235OTHERPENNSYLVANIARR MEDICARE
710743OTHERPENNSYLVANIAHEALTHPARTNERS
85517907MEDICAIDNEW JERSEY
91010825OTHERPENNSYLVANIAMERCY
10140847OTHERPENNSYLVANIABLUE SHIELD
11273218OTHERPENNSYLVANIAMAMSI

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.