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DEDICATED SENIOR MEDICAL CENTER SOUTH PHILADELPHIA
NPI 1023655602
Internal Medicine in Philadelphia, PA

Active since December 03, 2019CLIA 39D2187975 · Waiver
330 W OREGON AVE # 170, PHILADELPHIA, PA 19148(305) 628-6117 Get Directions Write a Review

NPPES record last updated: October 31, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 19, 2024, Feb 14, 2023, Jun 18, 2020 and 1 more (4 updates tracked since 2019).

About Dedicated Senior Medical Center South Philadelphia NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEDICATED SENIOR MEDICAL CENTER SOUTH PHILADELPHIA (NPI 1023655602) is a healthcare organization registered as an internal medicine in Philadelphia, Pennsylvania and active in the NPI registry since December 2019. The organization holds a CLIA Waiver certificate valid through July 9, 2028 and lists Mary Chen, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1023655602
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameDEDICATED PENNSYLVANIA HOLDING, LLC
Location Address330 W OREGON AVE # 170Philadelphia, PA 19148-4723
Mailing Address1395 Nw 167th StMiami Gardens, FL 33169-5710
Phone(305) 628-6117
Organization SubpartYes
Authorized OfficialMary ChenAuthorized Official · (305) 831-4722
Enumeration DateDecember 3, 2019
Last NPPES UpdateOctober 31, 20244 updates tracked since enumeration
NPPES CertifiedOctober 31, 2024
✔ NPI 1023655602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedNon-Pharmacy Dispensing SiteTaxonomy 332900000X
330 W OREGON AVE # 170, Philadelphia, PA 19148
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Other Names 1

Doing Business AsDedicated Senior Medical Center South Philadelphia

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D2187975

Dedicated Senior Medical Center - Whitman · Philadelphia, PA
Active · expires Jul 9, 2028
CLIA Number39D2187975
Laboratory TypePhysician Office
Certificate Effective DateJuly 10, 2026
Certificate Expiration DateJuly 9, 2028
Laboratory DirectorDr. Sumit Kumar
Laboratory Phone(267) 566-7211
Laboratory LocationDedicated Senior Medical Center - Whitman330 West Oregon Ave, Philadelphia, PA 19148
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dedicated Pennsylvania Holding, LLC's NPI number?

The NPI number for Dedicated Pennsylvania Holding, LLC is 1023655602. It was assigned to this organization in the NPPES registry on December 3, 2019. The provider is doing business as Dedicated Senior Medical Center South Philadelphia.

Where is Dedicated Pennsylvania Holding, LLC located?

Dedicated Pennsylvania Holding, LLC is located at 330 W Oregon Ave # 170, Philadelphia, PA 19148. The listed phone number is (305) 628-6117.

What is Dedicated Pennsylvania Holding, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Dedicated Pennsylvania Holding, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D2187975) is associated with this NPI, valid through July 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dedicated Pennsylvania Holding, LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 32 other insurers list Dedicated Pennsylvania Holding, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dedicated Pennsylvania Holding, LLC was last updated on October 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.