Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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University of Penn-Medical Group

Organization Sports Medicine (Family Medicine) Physician · NPI 1598153603

University of Penn-Medical Group is a Sports Medicine (Family Medicine) Physician in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2014.

Licensed in
PA
In the registry since
2014
Specialties on file
10
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Practice location Address checks out

3400 Spruce St 2 Silverstein Bldg
Philadelphia, PA 19104-4238
Phone: (215) 662-3340
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Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X (PA)
Sports Medicine (Family Medicine) Physician Taxonomy 207QS0010X (PA)
Orthopaedic Hand Surgery Physician Taxonomy 207XS0106X (PA)
Adult Reconstructive Orthopaedic Surgery Physician Taxonomy 207XS0114X (PA)
Orthopaedic Surgery of the Spine Physician Taxonomy 207XS0117X (PA)
Orthopaedic Foot and Ankle Surgery Physician Taxonomy 207XX0004X (PA)
Sports Medicine (Orthopaedic Surgery) Physician Taxonomy 207XX0005X (PA)
Orthopaedic Trauma Physician Taxonomy 207XX0801X (PA)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X (PA)
Plastic Surgery Physician Taxonomy 208200000X (PA)

Record details

NPI number1598153603
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chante Jackson — Enrollment · (215) 662-6187
NPI enumeratedDecember 26, 2014
Last updated in NPPESNovember 19, 2020
Certification dateNovember 19, 2020
Mailing address3400 Spruce St, 2 Silverstein Building, Philadelphia, PA 19104-4238

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