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)
Dedicated Pennsylvania Holding, LLC is a Specialist organization in Philadelphia, PA (NPI 1477053569).
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
Frequently asked questions
- What is Dedicated Pennsylvania Holding, LLC's NPI number?
- Dedicated Pennsylvania Holding, LLC's National Provider Identifier (NPI) is 1477053569, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Dedicated Pennsylvania Holding, LLC?
- Dedicated Pennsylvania Holding, LLC is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is Dedicated Pennsylvania Holding, LLC located?
- Dedicated Pennsylvania Holding, LLC's practice location on file with NPPES is 6431 Sackett St, Philadelphia, PA 19149-3118.
- What is Dedicated Pennsylvania Holding, LLC's phone number?
- The practice phone number listed in the NPPES registry for Dedicated Pennsylvania Holding, LLC is (305) 628-6117.
- Does Dedicated Pennsylvania Holding, LLC accept Medicare?
- Dedicated Pennsylvania Holding, LLC 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 Dedicated Pennsylvania Holding, LLC?
- The authorized official listed on Dedicated Pennsylvania Holding, LLC's NPPES record is Raymond Jimenez, Director of Client Services. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Dedicated Pennsylvania Holding, LLC's NPI active?
- Yes — Dedicated Pennsylvania Holding, LLC's NPI (1477053569) is active in the NPPES registry as of the last update on 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.