Devoted Medical P.c. | |
100 S Juniper St Fl 3 Philadelphia PA 19107-1316 | |
(866) 849-0692 | |
(888) 973-8821 |
Full Name | Devoted Medical P.c. |
---|---|
Speciality | Clinic/Center |
Location | 100 S Juniper St Fl 3, Philadelphia, Pennsylvania |
Authorized Official Name and Position | Aracely Courtney (PRACTICE MANAGEMENT) |
Authorized Official Contact | 8668490692 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Devoted Medical P.c. Po Box 211699 Eagan MN 55121-3699 Ph: (866) 849-0692 | Devoted Medical P.c. 100 S Juniper St Fl 3 Philadelphia PA 19107-1316 Ph: (866) 849-0692 |
NPI Number | 1114642683 |
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Provider Enumeration Date | 10/07/2022 |
Last Update Date | 01/05/2024 |
Medicare PECOS PAC ID | 6608249743 |
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Medicare Enrollment ID | O20230310000903 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114642683 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Secondary |
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Matthew D Mendillo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467090415 PECOS PAC ID: 8123459773 Enrollment ID: I20200514001285 |
Provider Name | Stephanie Trembulak |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548702806 PECOS PAC ID: 1951725233 Enrollment ID: I20200701001299 |
Provider Name | Kalee Linda Gresko |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780357293 PECOS PAC ID: 9032507082 Enrollment ID: I20211025003257 |
Provider Name | Robert Glass |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1497049571 PECOS PAC ID: 5991922999 Enrollment ID: I20230824001123 |
Provider Name | Kendra Hurst |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780156844 PECOS PAC ID: 3870839491 Enrollment ID: I20240402000353 |
Provider Name | Sara Modeste |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881785426 PECOS PAC ID: 8224298112 Enrollment ID: I20240419000074 |
Provider Name | Miranda Caccamise |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831539436 PECOS PAC ID: 3476782095 Enrollment ID: I20240425001434 |
Provider Name | Daniel Horn |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1780903971 PECOS PAC ID: 8224277991 Enrollment ID: I20240510003395 |
Provider Name | Andrew Sumarsono |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1750822094 PECOS PAC ID: 3577980564 Enrollment ID: I20240513002173 |
Provider Name | Meghan Mcgrath |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1689883134 PECOS PAC ID: 9638261241 Enrollment ID: I20240514000341 |
Provider Name | Alec Petersen |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1013370568 PECOS PAC ID: 1153618186 Enrollment ID: I20240520001725 |
Provider Name | Trisha Np Khalilieh |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922547439 PECOS PAC ID: 1052695665 Enrollment ID: I20240522003226 |
Provider Name | Susana Guzman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871963769 PECOS PAC ID: 5698061448 Enrollment ID: I20240523003184 |
Provider Name | Carolyn Mcelhinney |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326358425 PECOS PAC ID: 3870772908 Enrollment ID: I20240610001748 |
Provider Name | Jocelyn Butler |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215288360 PECOS PAC ID: 6507167392 Enrollment ID: I20240613004625 |
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