VITAL HEALTH PRIMARY CARE LLC
NPI 1992315659
Clinic/Center - Primary Care in Huntingdon Valley, PA
About Vital Health Primary Care Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VITAL HEALTH PRIMARY CARE LLC (NPI 1992315659) is a healthcare organization registered as a primary care in Huntingdon Valley, Pennsylvania and active in the NPI registry since August 2020. The organization holds a CLIA Waiver certificate valid through April 21, 2028 and lists Jessly Alex, Authorized Signatory, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Vital Health Primary Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Vital Health Primary Care LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Huntingdon Valley, PA 19006
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 39D2258473
Vital Health Primary Care LLC · Huntingdon Valley, PAFrequently 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 Vital Health Primary Care LLC's NPI number?
The NPI number for Vital Health Primary Care LLC is 1992315659. It was assigned to this organization in the NPPES registry on August 6, 2020.
Where is Vital Health Primary Care LLC located?
Vital Health Primary Care LLC is located at 930 Henrietta Ave Ste C, Huntingdon Valley, PA 19006. The listed phone number is (215) 663-9380.
What is Vital Health Primary Care LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Vital Health Primary Care LLC enrolled in Medicare?
Yes. Vital Health Primary Care LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Vital Health Primary Care LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Vital Health Primary Care LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Vital Health Primary Care LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 39D2258473) is associated with this NPI, valid through April 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Vital Health Primary Care LLC accept?
Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Vital Health Primary Care 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 Vital Health Primary Care LLC was last updated on September 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.
# Vital Health Primary Care Llc · NPI 1992315659
Primary Care organization in Huntingdon Valley, Pennsylvania. Organization record, active in the CMS NPPES registry since August 6, 2020.
## Identity
- **NPI:** 1992315659 (Entity type: Organization)
- **Enumerated:** August 6, 2020
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Jessly Alex, AUTHORIZED SIGNATORY
## Practice location
- **Address:** 930 HENRIETTA AVE STE C, Huntingdon Valley, PA 19006-8523
- **Phone:** (215) 663-9380 · **Fax:** (215) 663-9383
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 9, 2021
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1992315659) · Data from the CMS NPPES public registry.