|
| |
|
2144 Cecil B Moore Ave Philadelphia PA 19121-4014 | |
| (215) 320-6187 | |
| (215) 235-4441 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 2144 Cecil B Moore Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Anita Richardson (BILLING SUPERVISOR) |
| Authorized Official Contact | 2153206192 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2144 Cecil B Moore Ave Philadelphia PA 19121-4014 Ph: (215) 320-6192 | 2144 Cecil B Moore Ave Philadelphia PA 19121-4014 Ph: (215) 320-6187 |
| NPI Number | 1609122506 |
|---|---|
| Provider Enumeration Date | 07/28/2012 |
| Last Update Date | 05/29/2024 |
| Medicare PECOS PAC ID | 5799930822 |
|---|---|
| Medicare Enrollment ID | O20130221000265 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609122506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Michael S Weinstein |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1750301453 PECOS PAC ID: 9537124375 Enrollment ID: I20041122000439 |
| Provider Name | Lara Carson Weinstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861411274 PECOS PAC ID: 1153370457 Enrollment ID: I20050113000442 |
| Provider Name | Mary St Ledger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730593062 PECOS PAC ID: 7416274402 Enrollment ID: I20150401001114 |
| Provider Name | Kara M Cohen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538591383 PECOS PAC ID: 0244532646 Enrollment ID: I20151231000302 |
| Provider Name | Lydia A Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962830836 PECOS PAC ID: 6901109628 Enrollment ID: I20160129000261 |
| Provider Name | Patrick Martin Doggett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124384573 PECOS PAC ID: 2769615699 Enrollment ID: I20160610000063 |
| Provider Name | Christine Marie Castellan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144663717 PECOS PAC ID: 8729205430 Enrollment ID: I20160705001336 |
| Provider Name | Ivel Cheleili Morales |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770878456 PECOS PAC ID: 7214168459 Enrollment ID: I20180109002848 |
| Provider Name | Nyasha Kianne George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801138334 PECOS PAC ID: 8022241991 Enrollment ID: I20190911003126 |
| Provider Name | Nayeli Arguelles Spahr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073969929 PECOS PAC ID: 9537499728 Enrollment ID: I20191002000487 |
| Provider Name | Joseph Beeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518508837 PECOS PAC ID: 1557793940 Enrollment ID: I20191125001167 |
| Provider Name | Elise Jost Paquin |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1518353754 PECOS PAC ID: 2062760838 Enrollment ID: I20230614000609 |
Laura Yatvin Nutrition Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4231 N. 5th Street, Philadelphia, PA 19140 Phone: 215-455-5370 Fax: 215-455-5374 | |
Health Hero Pa Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 217 Dickinson St, Philadelphia, PA 19147 Phone: 484-667-3382 | |
Vo Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1735 Market St Fl 52, Philadelphia, PA 19103 Phone: 267-314-7252 | |
Rooted Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3101 Tyson Ave, Philadelphia, PA 19149 Phone: 917-861-2531 | |
Care Health Partners Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1308 Cottman Ave, Philadelphia, PA 19111 Phone: 732-766-1827 Fax: 609-890-0950 | |
University Of Penn - Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3400 Spruce St, 3 Ravdin, Suite F, Pulmonary & Critical Care, Philadelphia, PA 19104 Phone: 215-662-3202 | |