Dedicated Pennsylvania Holding, LLC
NPI 1477053569 · Specialist · Philadelphia, PA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1477053569
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Parent organization
- Dedicated Pennsylvania Mayfair
- Organization subpart
- Yes
- Authorized official
- Raymond Jimenez, Director of Client Services(786) 870-4039
Specialties & taxonomies
Other Service Providers
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
- Non-Pharmacy Dispensing Site332900000X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 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
Other names (DBA / former)
- Doing business as
- Dedicated Pennsylvania Mayfair
- Doing business as
- Dedicated Pennsylvania Mayfair
Registry dates
- Enumerated
- 2018-02-15
- Last updated
- 2018-03-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.