INNOVAGE PENNSYLVANIA LIFE, LLC
NPI 1104954569
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization in Philadelphia, PA
NPI Status: Active since February 28, 2007
Contact Information
6950 GERMANTOWN AVE
PHILADELPHIA, PA
ZIP 19119
Phone: (215) 951-4304
Fax: (267) 286-4910
- Organization
- Program of All-Inclusive Care for the El...
- CLIA Number: 39D1065315
- CLIA Cert. Type: Other
- CLIA Exp. Date: 02-26-2027
About INNOVAGE PENNSYLVANIA LIFE, LLC
This page provides the complete NPI Profile along with additional information for Innovage Pennsylvania Life, Llc, a provider established in Philadelphia, Pennsylvania operating as a Program Of All-inclusive Care For The Elderly (pace) Provider Organization. The healthcare provider is registered in the NPI registry with number 1104954569 assigned on February 2007. The practitioner's primary taxonomy code is 251T00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Gayle M Washington (Credentialing Director)
- NPI
- 1104954569
- Provider Name
- INNOVAGE PENNSYLVANIA LIFE, LLC
- Entity Type
- Organization
- Location Address
- 6950 GERMANTOWN AVE PHILADELPHIA, PA 19119
- Location Phone
- (215) 951-4304
- Location Fax
- (267) 286-4910
- Mailing Address
- 6950 GERMANTOWN AVE PHILADELPHIA, PA 19119
- Mailing Phone
- (215) 951-4304
- Mailing Fax
- (267) 286-4910
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-28-2007
- Last Update Date
- 04-04-2019
- Code Navigator
Location Map
Secondary Locations
- 6970 Germantown Ave
Philadelphia, PA 19119
(215) 951-4400 - 6970 Germantown Ave
Philadelphia, PA 19119
(215) 951-4400 - 6950 Germantown Ave
Philadelphia, PA 19119
(215) 951-4304
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization
- Taxonomy Code
- 251T00000X
- Type
- Agencies
- Taxonomy Description
- A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1017342560001 | MEDICAID (05) | PA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 39D1065315
- Facility Type
- Other
- Certificate Effective Date
- February 27, 2025
- Certificate Expiration Date
- February 26, 2027
- Laboratory Director
- DR. LUZ S. RAMOS BONNER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Innovage Pennsylvania Life, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104954569, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 18 providers are registered at the same or a nearby location.
PHILADELPHIA, PA 19119
PHILADELPHIA, PA 19119
PHILADELPHIA, PA 19119
PHILADELPHIA, PA 19119
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104954569, enumerated as an "organization" on February 28, 2007.
The provider is located at 6950 GERMANTOWN AVE PHILADELPHIA, PA 19119 and the phone number is (215) 951-4304.
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization with taxonomy code 251T00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
