Residentialist Housecall Med Grp, PC a Pennsylvania Corp
NPI 1104205400 · Geriatric Medicine (Family Medicine) Physician · Philadelphia, PA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Residentialist Housecall Med Grp, PC a Pennsylvania Corp is a Geriatric Medicine (Family Medicine) Physician organization in Philadelphia, PA (NPI 1104205400).
Provider details
- NPI number
- 1104205400
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Marie Walton, Billing Manager(949) 366-1053
- License
- OS017618 (PA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2015-05-20
- Last updated
- 2025-03-05
- Certified
- 2025-03-05
Frequently asked questions
- What is Residentialist Housecall Med Grp, PC a Pennsylvania Corp's NPI number?
- Residentialist Housecall Med Grp, PC a Pennsylvania Corp's National Provider Identifier (NPI) is 1104205400, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Residentialist Housecall Med Grp, PC a Pennsylvania Corp?
- Residentialist Housecall Med Grp, PC a Pennsylvania Corp is classified in the NPPES registry as Geriatric Medicine (Family Medicine) Physician (Allopathic & Osteopathic Physicians).
- Where is Residentialist Housecall Med Grp, PC a Pennsylvania Corp located?
- Residentialist Housecall Med Grp, PC a Pennsylvania Corp's practice location on file with NPPES is 4190 City Ave, Philadelphia, PA 19131-1626.
- What is Residentialist Housecall Med Grp, PC a Pennsylvania Corp's phone number?
- The practice phone number listed in the NPPES registry for Residentialist Housecall Med Grp, PC a Pennsylvania Corp is (949) 366-1053.
- Does Residentialist Housecall Med Grp, PC a Pennsylvania Corp accept Medicare?
- Residentialist Housecall Med Grp, PC a Pennsylvania Corp is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Residentialist Housecall Med Grp, PC a Pennsylvania Corp?
- The authorized official listed on Residentialist Housecall Med Grp, PC a Pennsylvania Corp's NPPES record is Marie Walton, Billing Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Residentialist Housecall Med Grp, PC a Pennsylvania Corp's NPI active?
- Yes — Residentialist Housecall Med Grp, PC a Pennsylvania Corp's NPI (1104205400) is active in the NPPES registry as of the last update on 2025-03-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.