University Of Penn - Medical Group - Medicare Primary Care in Philadelphia, PA

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University Of Penn - Medical Group is a medicare enrolled primary clinic (Internal Medicine - Geriatric Medicine) in Philadelphia, Pennsylvania. The current practice location for University Of Penn - Medical Group is 3615 Chestnut St, Ralston-penn Center, Philadelphia, Pennsylvania. For appointments, you can reach them via phone at (215) 662-2746. The mailing address for University Of Penn - Medical Group is 3615 Ralston Center, Ralston Penn Center, Philadelphia, Pennsylvania and phone number is () -.

University Of Penn - Medical Group is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1497767495. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (215) 662-2746.

Contact Information

University Of Penn - Medical Group
3615 Chestnut St
Ralston-penn Center
Philadelphia
PA 19104-2612
(215) 662-2746
(215) 349-5648

Map and Direction


Primary Care Clinic Profile

Full NameUniversity Of Penn - Medical Group
SpecialityInternal Medicine
Location3615 Chestnut St, Philadelphia, Pennsylvania
Authorized Official Name and PositionChante L Jackson (ENROLLMENT LEAD)
Authorized Official Contact2156626187
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
University Of Penn - Medical Group
3615 Ralston Center
Ralston Penn Center
Philadelphia
PA 19104-2612

Ph: () -		University Of Penn - Medical Group
3615 Chestnut St
Ralston-penn Center
Philadelphia
PA 19104-2612

Ph: (215) 662-2746

NPI Details:

NPI Number1497767495
Provider Enumeration Date08/12/2006
Last Update Date11/19/2020

Medicare PECOS Information:

Medicare PECOS PAC ID6204730955
Medicare Enrollment IDO20141120002039

Medical Identifiers

Medical identifiers for University Of Penn - Medical Group such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1497767495NPI-NPPES
1010530OtherPAMERCY
CA0235OtherPARR MEDICARE
496703OtherPAAETNA
0006610360MedicaidPA
5466407OtherNJNJ-MEDICAID
11192OtherPAHEALTH PARTNERS
0002Y20116OtherPAHEALTHNET
0270301000OtherPAKEYSTONE
043052OtherPABLUE SHIELD
273211OtherPAMAMSI
G0005268OtherPAAMERICHOICE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Secondary
207R00000XInternal Medicine (* (Not Available))Secondary
207RG0300XInternal Medicine - Geriatric Medicine (* (Not Available))Primary
207RP1001XInternal Medicine - Pulmonary Disease (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. University Of Penn - Medical Group acts as a billing entity for following providers:
Provider NameJason H Karlawish
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1972546281
PECOS PAC ID: 3577556802
Enrollment ID: I20040405000436
Provider NameNalaka Sudhee Gooneratne
Provider TypePractitioner - Sleep Medicine
Provider IdentifiersNPI Number: 1235170663
PECOS PAC ID: 8729068044
Enrollment ID: I20040726000494
Provider NameJohanne Louis Taylor
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588611446
PECOS PAC ID: 9032183561
Enrollment ID: I20040821000009
Provider NameJoshua Daniel Uy
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1164422564
PECOS PAC ID: 7517936404
Enrollment ID: I20040928000516
Provider NameJean G Yudin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700940012
PECOS PAC ID: 1456392067
Enrollment ID: I20050513000230
Provider NameCarissa Sharnetta Fuller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407070501
PECOS PAC ID: 8224136239
Enrollment ID: I20070614000078
Provider NameBruce P Kinosian
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1871536177
PECOS PAC ID: 1052477528
Enrollment ID: I20090309000099
Provider NameMary Ann Forciea
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1992746754
PECOS PAC ID: 6103952890
Enrollment ID: I20100406000132
Provider NameJerry C Johnson
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1669415972
PECOS PAC ID: 2264568708
Enrollment ID: I20100412000016
Provider NameJohn M Bruza
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1093758310
PECOS PAC ID: 5991831430
Enrollment ID: I20100412000021
Provider NameJoan B Weinryb
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1194768499
PECOS PAC ID: 1355478371
Enrollment ID: I20100423000220
Provider NameLesley S Carson
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1962443390
PECOS PAC ID: 3870621857
Enrollment ID: I20100512000723
Provider NameWilliam Edwards
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992869200
PECOS PAC ID: 8921139502
Enrollment ID: I20100625000364
Provider NameStephen J Gluckman
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1932136850
PECOS PAC ID: 8022298298
Enrollment ID: I20110204000231
Provider NameKira L Ryskina
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1790002731
PECOS PAC ID: 7214162999
Enrollment ID: I20131105001376
Provider NameCatherine M Strohl
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1427473255
PECOS PAC ID: 0042433773
Enrollment ID: I20140527000188
Provider NameAlysa Beth Krain
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1205272499
PECOS PAC ID: 3779473749
Enrollment ID: I20140708001037
Provider NameLinda J Schreiber Williams
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528476454
PECOS PAC ID: 4981823085
Enrollment ID: I20140923001366
Provider NameSoumya Bollampally
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1205156445
PECOS PAC ID: 9032425517
Enrollment ID: I20150828000829
Provider NamePatricia A Boken
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1376523977
PECOS PAC ID: 8426336108
Enrollment ID: I20161101000288
Provider NameVimmie Viresh Panchal
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1154764355
PECOS PAC ID: 1456594845
Enrollment ID: I20170726000438
Provider NameLaura Pendleton Okami
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1952853319
PECOS PAC ID: 6305110818
Enrollment ID: I20170922000106
Provider NameKeisha Ward
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1962744086
PECOS PAC ID: 6800194937
Enrollment ID: I20171010001392
Provider NameShannon Mone Eimer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972028140
PECOS PAC ID: 7719253558
Enrollment ID: I20171024001582
Provider NameRobert E Burke
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1003074790
PECOS PAC ID: 2567749997
Enrollment ID: I20180529000784
Provider NameLisa Maria Walke
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1548243751
PECOS PAC ID: 6406984061
Enrollment ID: I20180618001568
Provider NameMark J Simone-skdimore
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1568681609
PECOS PAC ID: 5395812564
Enrollment ID: I20180924002501
Provider NameAlyson R Michener
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1649667684
PECOS PAC ID: 1951639764
Enrollment ID: I20190817000167
Provider NameJennifer Giddings
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649636317
PECOS PAC ID: 8426342213
Enrollment ID: I20191118002568
Provider NameRose Onyeali
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1689028847
PECOS PAC ID: 7810282746
Enrollment ID: I20200507000785
Provider NameMegha Patel
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1013398486
PECOS PAC ID: 1052665445
Enrollment ID: I20200909000742
Provider NameKristina Kitano
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992229645
PECOS PAC ID: 8729490420
Enrollment ID: I20210903000032
Provider NameDayna Catherine Hovern
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1811494693
PECOS PAC ID: 1355694373
Enrollment ID: I20220519000820
Provider NameTheresa Banmeke
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861125197
PECOS PAC ID: 5294118188
Enrollment ID: I20220810000068
Provider NameMelanie Tupino Brendia
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811586910
PECOS PAC ID: 9830574987
Enrollment ID: I20220910000098
Provider NameRolando Humberto Vega
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104548221
PECOS PAC ID: 6901275189
Enrollment ID: I20221209001540
Provider NameKatharine Grace Burke
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336851757
PECOS PAC ID: 6608248000
Enrollment ID: I20230213001668
Provider NameEva Szymanski
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1699210732
PECOS PAC ID: 6800126608
Enrollment ID: I20231010000041
Provider NameJessica Xin Ying Zuo
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1760979199
PECOS PAC ID: 0840548830
Enrollment ID: I20231102001031
Provider NameLilli Flink
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1417410333
PECOS PAC ID: 2567798267
Enrollment ID: I20231109003189
Provider NameApril Nicole Powell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801554308
PECOS PAC ID: 7719327121
Enrollment ID: I20240502002004
Provider NameStephanie Yanni
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518133164
PECOS PAC ID: 9133579782
Enrollment ID: I20240909001467
Provider NameScott Snyder
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1710325717
PECOS PAC ID: 1557593373
Enrollment ID: I20241011000842

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.