UNIVERSITY OF PENN-MEDICAL GROUP


Address: 3400 Spruce St, Ground Floor Dulles, Philadelphia, PA 19104-4238
Phone: 2156623005

UNIVERSITY OF PENN-MEDICAL GROUP (NPI# 1558759571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1558759571
Entity Type Organization
Organization Name UNIVERSITY OF PENN-MEDICAL GROUP
Practice Address 3400 Spruce St
Ground Floor Dulles
Philadelphia
PA 19104-4238
Practice Telephone 2156623005
Mailing Telephone 2156623005
Enumeration Date 2014-12-29
Last Update Date 2014-12-29
Authorized Official Name ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
Authorized Official Telephone 2156627583
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207U00000X Nuclear Medicine PA Allopathic & Osteopathic Physicians
N 2085N0700X Radiology
Specialization: Neuroradiology
PA Allopathic & Osteopathic Physicians
N 2085N0904X Radiology
Specialization: Nuclear Radiology
PA Allopathic & Osteopathic Physicians
N 2085P0229X Radiology
Specialization: Pediatric Radiology
PA Allopathic & Osteopathic Physicians
N 2085R0204X Radiology
Specialization: Vascular & Interventional Radiology
PA Allopathic & Osteopathic Physicians
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
PA Allopathic & Osteopathic Physicians

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1396193900 University of Penn-medical Group Transplant Surgery 1501 N Cedar Crest Blvd, Suite 110 Liver Transplant, Allentown, PA 18104-2309 2016-05-25
1821451139 University of Penn-medical Group Internal Medicine 554 N Duke St, 3rd Floor Renal Transplant, Lancaster, PA 17602-2225 2016-04-04
1902269210 University of Penn-medical Group Surgery 554 N Duke St, 3rd Floor, Lancaster, PA 17602-2225 2016-04-04
1043670805 University of Penn-medical Group Internal Medicine 554 N Duke St, 3rd Floor Gi Transplant, Lancaster, PA 17602-2225 2016-03-07
1730578667 University of Penn-medical Group Internal Medicine 3400 Spruce St, Ground Floor Donner, Philadelphia, PA 19104-4238 2015-01-15
1073902169 University of Penn-medical Group Dermatology 3400 Spruce St, 2 Rhoads Pavilion, Philadelphia, PA 19104-4238 2015-01-13
1184012569 University of Penn-medical Group Clinical Medical Laboratory 3400 Spruce St, Philadelphia, PA 19104-4238 2015-01-07
1821486846 University of Penn-medical Group Marriage & Family Therapist 3535 Market St, 3rd Floor, Philadelphia, PA 19104-3309 2014-12-29
1740678762 University of Penn-medical Group Pathology 3400 Spruce St, Philadelphia, PA 19104-4238 2014-12-29
1811385834 University of Penn-medical Group Thoracic Surgery (Cardiothoracic Vascular Surgery) 51 N 39th St, 266 Wright Saunders, Philadelphia, PA 19104-2640 2014-12-29

Office Location

Street Address 3400 SPRUCE ST
GROUND FLOOR DULLES
City PHILADELPHIA
State PA
Zip Code 19104-4238

Providers in the same location

NPI Name Taxonomy Address Enumeration
1063415966 Samuel Isaiah Parry Obstetrics & Gynecology 3400 Spruce St, Philadelphia, PA 19104-4238 2005-05-24
1831790609 Renate Marie Balitzky Registered Nurse 3400 Spruce St, Philadelphia, PA 19104-4238 2020-11-06
1053911156 Jordan Charles Templeton Physician Assistant 3400 Spruce St, Philadelphia, PA 19104-4274 2020-10-28
1992305304 Alyssa N Volpe Registered Nurse 3400 Spruce St, Philadelphia, PA 19104-4238 2020-10-27
1700486115 Christina Haddow Registered Nurse 3400 Spruce St, Philadelphia, PA 19104-4238 2020-10-27
1629677497 Marissa Leigh Berlant Physician Assistant 3400 Spruce St, Philadelphia, PA 19104-4238 2020-10-22
1811595523 Kristen Gilgen Anesthesiology 3400 Spruce St, Philadelphia, PA 19104-4238 2020-10-14
1962014654 Stacey Pham Nurse Practitioner 3400 Spruce St, Philadelphia, PA 19104-4238 2020-08-23
1265040109 Abdullah T Almuqate Pathology 3400 Spruce St, Philadelphia, PA 19104-4238 2020-07-16
1952928541 Stefen Andrianus Student in an Organized Health Care Education/Training Program 3400 Spruce St, Philadelphia, PA 19104-4238 2020-06-29
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1639770829 Michelle Morris Student in an Organized Health Care Education/Training Program Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 2020-11-04
1346853041 Spectrum Health Services, Inc. Clinic/Center 1415 South University Ave, Philadelphia, PA 19104 2020-08-24
1770104259 Fatimah Sorefan-mangou Student in an Organized Health Care Education/Training Program 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 2020-05-06
1114548690 Rebecca Blaguski Registered Nurse The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 2020-05-06
1952944175 Rebecca Miriam Barmherzig Psychiatry & Neurology 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 2019-10-21
1891257101 James Paul Byrne Surgery Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 2019-04-04
1093276453 Lauren Shreve Student in an Organized Health Care Education/Training Program Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 2019-03-28
1285194282 Lauren M Christie Student in an Organized Health Care Education/Training Program Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 2019-03-25
1114487683 Sabrina Layne Student in an Organized Health Care Education/Training Program 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 2019-03-21
1811457310 Kia Lor Student in an Organized Health Care Education/Training Program Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 2019-03-21
Find all providers in zip 19104

Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063067635 Jefferson University Radiology Associates, LLC Radiology 3 Crescent Dr Ste 1002, Philadelphia, PA 19112-1016 2019-08-09
1033649975 Dinh-huy Do Nguyen Radiology 5501 Old York Rd Ste 363, Philadelphia, PA 19141-3018 2017-06-13
1467809418 Jeffrey Burgess Radiology 1215 Spruce St Apt 201, Philadelphia, PA 19107-5620 2016-05-19
1649632399 Myron Blumberg Radiology 317 S 22nd St, Philadelphia, PA 19103-6528 2016-03-22
1144633074 Daniel Robert Wahl Radiology 3400 Spruce Street - 1 Silverstein, Department of Radiology / Abdominal Imaging, Philadelphia, PA 19104 2014-06-09
1235564337 Ron Benjamin Radiology 2055 E Fletcher St, Philadelphia, PA 19125 2013-09-08
1831454867 Ryan Michael Bonshock Radiology 4220 Market St Fl 2, Philadelphia, PA 19104-3007 2012-07-05
1730498601 Robert A Perkins Jr. Radiology 132 S 10th St Ste 1099j, Philadelphia, PA 19107-5244 2010-09-27
1457677007 Michael Richard Acord Radiology 3401 Civic Blvd, Division of Radiology, Philadelphia, PA 19104 2010-04-07
1780918375 Mollie Mcginley Radiology 1835 Arch St, Apartment 305, Philadelphia, PA 19103-2712 2009-09-29
Find all providers in PHILADELPHIA

Competitor

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City PHILADELPHIA
Zip Code 19104

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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