| Spectrum Health Services, Inc. | |
|
5201 Haverford Ave Philadelphia PA 19139-1401 | |
| (215) 472-6095 | |
| Not Available |
| Full Name | Spectrum Health Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 5201 Haverford Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Phyllis Cater (PRESIDENT/CEO) |
| Authorized Official Contact | 2154723240 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectrum Health Services, Inc. 5201 Haverford Ave Philadelphia PA 19139-1401 Ph: () - | Spectrum Health Services, Inc. 5201 Haverford Ave Philadelphia PA 19139-1401 Ph: (215) 472-6095 |
| NPI Number | 1265866107 |
|---|---|
| Provider Enumeration Date | 08/28/2013 |
| Last Update Date | 08/28/2013 |
| Medicare PECOS PAC ID | 0840242467 |
|---|---|
| Medicare Enrollment ID | O20050211000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265866107 | NPI | - | NPPES |
| 1007288260005 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Jeffrey K Dunbar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659344695 PECOS PAC ID: 1052364213 Enrollment ID: I20050228000689 |
| Provider Name | Linda Wolf Greenberg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932148681 PECOS PAC ID: 2466407432 Enrollment ID: I20050314000441 |
| Provider Name | Mario P Demarco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821291626 PECOS PAC ID: 7911030465 Enrollment ID: I20100804000209 |
| Provider Name | Myron L Sewell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528089612 PECOS PAC ID: 1456484856 Enrollment ID: I20110404000658 |
| Provider Name | Courtney M Powell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801058417 PECOS PAC ID: 8527239607 Enrollment ID: I20110921000471 |
| Provider Name | Shreya Kangovi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295891760 PECOS PAC ID: 2264698745 Enrollment ID: I20120727000471 |
| Provider Name | Nekeisha Sunia Alexander Abdul-hakim |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1649568056 PECOS PAC ID: 4284850538 Enrollment ID: I20140801000096 |
| Provider Name | Akilah Masika Bates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578858353 PECOS PAC ID: 3072739127 Enrollment ID: I20140908000274 |
| Provider Name | Aqiyla Muhammad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174685689 PECOS PAC ID: 5799905147 Enrollment ID: I20141007000209 |
| Provider Name | David Lemonte Gaines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992140800 PECOS PAC ID: 0446485197 Enrollment ID: I20150415001384 |
| Provider Name | Afua Mintah |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649413501 PECOS PAC ID: 7911186234 Enrollment ID: I20160202001169 |
| Provider Name | Hilary E Reichlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518253095 PECOS PAC ID: 9638475452 Enrollment ID: I20160304000029 |
| Provider Name | Anita Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932653037 PECOS PAC ID: 9830467414 Enrollment ID: I20170623000094 |
| Provider Name | Kimberly Downing |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417360009 PECOS PAC ID: 2264724087 Enrollment ID: I20180820001980 |
| Provider Name | Cara Christie Sottile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427523273 PECOS PAC ID: 4981946555 Enrollment ID: I20190501000040 |
| Provider Name | Jenny Wang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184070476 PECOS PAC ID: 8224365622 Enrollment ID: I20190807004004 |
| Provider Name | Kevin Subers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639523954 PECOS PAC ID: 9739472630 Enrollment ID: I20200103000284 |
| Provider Name | Naeemah Selby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437613395 PECOS PAC ID: 8921435025 Enrollment ID: I20200303000229 |
| Provider Name | Kimberlie Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164077384 PECOS PAC ID: 1759702855 Enrollment ID: I20200527003241 |
| Provider Name | Laura Ann Kurash |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154852945 PECOS PAC ID: 5890062491 Enrollment ID: I20200826000934 |
| Provider Name | Tanya Trewick Ryans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689056343 PECOS PAC ID: 6800151119 Enrollment ID: I20200916001777 |
| Provider Name | Myra Lynn Rutland |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1982246682 PECOS PAC ID: 1759793979 Enrollment ID: I20201211002663 |
| Provider Name | Sarah Pinto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396300331 PECOS PAC ID: 8527470392 Enrollment ID: I20201221000125 |
| Provider Name | Susan Breakell Gresko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184688343 PECOS PAC ID: 0648672105 Enrollment ID: I20210707001988 |
| Provider Name | Amy Wharton Holland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508356353 PECOS PAC ID: 8022411958 Enrollment ID: I20210729000942 |
| Provider Name | Sarah Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457818551 PECOS PAC ID: 4082946686 Enrollment ID: I20211123000209 |
| Provider Name | Inaisha Marie Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386005460 PECOS PAC ID: 8123418357 Enrollment ID: I20211202001611 |
| Provider Name | Carolyn B Wagner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508210931 PECOS PAC ID: 7214273648 Enrollment ID: I20220113000993 |
| Provider Name | Kassandra Petit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083290860 PECOS PAC ID: 2365851011 Enrollment ID: I20220216002291 |
| Provider Name | Ilan Joseph Resnick Caplan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720522857 PECOS PAC ID: 0840623658 Enrollment ID: I20220519002909 |
| Provider Name | Tan D Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609523802 PECOS PAC ID: 8123406444 Enrollment ID: I20220527000870 |
| Provider Name | Swetha Iruku |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780180174 PECOS PAC ID: 7810245453 Enrollment ID: I20220622002147 |
| Provider Name | Biancha Jackson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699477109 PECOS PAC ID: 0648645036 Enrollment ID: I20230418000587 |
| Provider Name | Chinyere Enyia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700360724 PECOS PAC ID: 7214390525 Enrollment ID: I20230901002243 |
| Provider Name | Elizabeth Wetterer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598393498 PECOS PAC ID: 4284088832 Enrollment ID: I20230929002626 |
| Provider Name | Heba Ali Rohiem Elghalban |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659900652 PECOS PAC ID: 4183046972 Enrollment ID: I20231030003271 |
| Provider Name | Joanne C Brice |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811977093 PECOS PAC ID: 7618980715 Enrollment ID: I20231107001092 |
| Provider Name | Brian Burman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528621984 PECOS PAC ID: 2264889310 Enrollment ID: I20231110000204 |
| Provider Name | Hye Jin Cha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972104487 PECOS PAC ID: 9830503382 Enrollment ID: I20231114000358 |
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