UNIVERSITY OF PENN - MEDICAL GROUP – NPI #1497767495
Internal Medicine

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 is a provider located in PHILADELPHIA, PA. NPPES has assigned the NPI number 1497767495 to UNIVERSITY OF PENN - MEDICAL GROUP on August 12, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RG0300X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Geriatric Medicine

The NPI profile was previously updated about 6 years ago on Nov 19, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for UNIVERSITY OF PENN - MEDICAL GROUP below.

NPI Profile for
UNIVERSITY OF PENN - MEDICAL GROUP

NPI Number
1497767495
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
UNIVERSITY OF PENN - MEDICAL GROUP
Primary location
3615 CHESTNUT ST
RALSTON-PENN CENTER
PHILADELPHIA, PA 19104-2612
Phone: (215) 662-2746 Fax: (215) 349-5648
Mailing address
3615 RALSTON CENTER
RALSTON PENN CENTER
PHILADELPHIA, PA 19104-2612
Phone: Fax:
Organization Subpart
No
Authorized Official
CHANTE JACKSON
ENROLLMENT LEAD
Phone: (215) 662-6187
Updated
Certification Date
Nov 19, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for UNIVERSITY OF PENN - MEDICAL GROUP

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

See identifiers
DescriptionIssuerStateIdentifier
OTHERAETNAPA496703
OTHERAMERICHOICEPAG0005268
OTHERBLUE SHIELDPA043052
OTHERHEALTH PARTNERSPA11192
OTHERHEALTHNETPA0002Y20116
OTHERKEYSTONEPA0270301000
OTHERMAMSIPA273211
OTHERMERCYPA1010530
OTHERNJ-MEDICAIDNJ5466407
OTHERRR MEDICAREPACA0235
MEDICAIDPA0006610360
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Endpoint type
CONNECT URL
Endpoint Description
2.16.840.1.113883.3.1068.1
Content Type
Affiliation
Y
Endpoint Location
2720 DUNDEE RD # 302,
NORTHBROOK, IL 77025-1669