OrganizationActive
Innovage Pennsylvania Life, LLC
NPI 1588279657 · PACE Provider Organization · Philadelphia, PA
Provider details
- NPI number
- 1588279657
- Entity type
- Organization
- Primary specialty
- PACE Provider OrganizationAgencies
- Parent organization
- Total Community Options Inc
- Organization subpart
- Yes
- Authorized official
- Vanessa Walton, Chief Legal Officer(303) 242-1352
Specialties & taxonomies
Agencies
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 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
4401 Megargee St
Philadelphia, PA 19136-2160
Phone: (844) 292-1028
Street-level locationGet directions
Mailing address
8950 E Lowry Blvd
Denver, CO 80230-7030
Other names (DBA / former)
- Doing business as
- Innovage Pennsylvania Life-Pennypack
Registry dates
- Enumerated
- 2020-09-15
- Last updated
- 2020-09-15
- Certified
- 2020-09-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.