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PEDIATRIC AND ADOLESCENT MEDICINE GROUP
NPI 1801836671
Pediatrics - Adolescent Medicine in Philadelphia, PA

Active since June 08, 2006CLIA 39D0698768 · Waiver
2129 W OREGON AVE, FIRST FLOOR REAR, PHILADELPHIA, PA 19145(215) 462-6106(215) 462-5922 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Aug 22, 2020 (2 updates tracked since 2020).

About Pediatric And Adolescent Medicine Group NPPES

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

PEDIATRIC AND ADOLESCENT MEDICINE GROUP (NPI 1801836671) is a healthcare organization registered as an adolescent medicine in Philadelphia, Pennsylvania and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through July 11, 2027 and lists Stella C Magliocco, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1801836671
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NamePEDIATRIC AND ADOLESCENT MEDICINE GROUP
Location Address2129 W OREGON AVE, FIRST FLOOR REARPhiladelphia, PA 19145-4131
Mailing Address2129 W Oregon Ave, First Floor RearPhiladelphia, PA 19145-4131 · (215) 462-6106 · Fax (215) 462-5922
Phone(215) 462-6106
Fax(215) 462-5922
Organization SubpartNo
Authorized OfficialStella C MaglioccoOffice Manager · 215462616
Enumeration DateJune 8, 2006
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1801836671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

2129 W OREGON AVE, Philadelphia, PA 19145
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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

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 39D0698768

Pediatric And Adolescent Med Group · Philadelphia, PA
Active · expires Jul 11, 2027
CLIA Number39D0698768
Laboratory TypePhysician Office
Certificate Effective DateJuly 12, 2025
Certificate Expiration DateJuly 11, 2027
Laboratory DirectorDr. Glenn H. Pisk
Laboratory Phone(215) 462-6106
Laboratory LocationPediatric And Adolescent Med Group1843 S Broad St, Philadelphia, PA 19148
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. AARON BORGMANN BS, MPT, ATC
Physical Therapist
2129 W OREGON AVE
PHILADELPHIA, PA 19145
Philadelphia County (215) 336-6630
MR. DEAN EARL PENUEL
Physical Therapist
2129 W OREGON AVE, 3RD FLOOR SUITE
PHILA, PA 19145
Philadelphia County (215) 336-6630
MR. JOHN ASHENBRENNER
Physical Therapist
2129 W OREGON AVE, 3RD FLOOR SUITE
PHILA, PA 19145
Philadelphia County (215) 336-6630
MISS SANDRA USTARIS
Physical Therapist
2129 W OREGON AVE
PHILA, PA 19145
Philadelphia County (215) 336-6630
MR. DAVID JOSEPH HILL PT
Physical Therapist
2129 W OREGON AVE
PHILA, PA 19145
Philadelphia County (215) 336-6630
MS. NICOLE MARGARET CANNON DPT
Physical Therapist
2129 W OREGON AVE
PHILADELPHIA, PA 19145
Philadelphia County (215) 336-6630
STEVEN R FELDMAN DPT
Physical Therapist
2129 W OREGON AVE
PHILADELPHIA, PA 19145
Philadelphia County (215) 336-6630
DR. SHARON M ELVEY M.D.
Pediatrics (Adolescent Medicine)
2129 W OREGON AVE, FIRST FLOOR REAR
PHILADELPHIA, PA 19145
Philadelphia County (215) 462-6106

Frequently Asked Questions

What is PEDIATRIC AND ADOLESCENT MEDICINE GROUP's NPI number?

The NPI number assigned to this healthcare provider is 1801836671, enumerated as an "organization" on June 08, 2006.

Where is the provider located?

The provider is located at 2129 W OREGON AVE FIRST FLOOR REAR PHILADELPHIA, PA 19145 and the phone number is (215) 462-6106.

What is the provider's specialty?

Pediatrics with taxonomy code 2080A0000X and a focus in Adolescent Medicine.