Innovage Pennsylvania Life, LLC
NPI 1023612264ActiveOrganization· PACE Provider Organization· Philadelphia, PA
PACE Provider Organization in Philadelphia, Pennsylvania, registered in NPPES in November 2020, part of Innovage Pennsylvania Life, LLC. The authorized official on file is Lezlie Corbin, Credentialing Coordinator.
Overview
| NPI | 1023612264 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Innovage Pennsylvania Life, LLC |
| NPI issued | Nov 29, 2020 |
| Last updated in NPPES | Nov 29, 2020 |
| Certified by provider | Nov 29, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| PACE Provider Organization Primary | 251T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other PACE Provider Organization providers in Philadelphia
- 1619739190
- 1013519735
- 1104954569
- 1467056655
- 1588279657
- 1881738565
- 1174881627
- 1710347661
- 1538210380
- 1619597747
- 1043683956
- 1083026082