TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION (NPI# 1104814128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104814128 |
| Entity Type | Organization |
| Organization Name | TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION |
| Other Organization Name | TEMPLE NEUROSURGICAL |
| Practice Address |
3509 N Broad St Philadelphia PA 19140-4105 |
| Mailing Address |
2450 W Hunting Park Ave Philadelphia PA 19129-1302 |
| Practice Telephone | 2157074105 |
| Practice Fax Number | 2157073831 |
| Mailing Telephone | 2157077200 |
| Mailing Fax Number | 2157073831 |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2018-06-15 |
| Authorized Official Name | TONYA WOODARD (CREDENTIALING/MANAGER) |
| Authorized Official Telephone | 2157073911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007780130804 | 05 | |
| PA | 1007780130802 | 05 | |
| PA | 1007780130824 | 05 | |
| PA | 1007780130803 | 05 |
| Other Name | Type Code |
|---|---|
| Temple Neurosurgical | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8815 Germantown Ave, Philadelphia, PA 191182722 | 2157077200 | 2157073831 |
| 7500 Central Ave, Philadelphia, PA 191112430 | 2157077200 | 2157073831 |
| 1650 Huntingdon Pike, Meadowbrook, PA 190468004 | 2157077200 | 2157073831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174096432 | Temple University of The Commonwealth System of Higher Education | Family Medicine | 2300 W Master St Ste 109b, Philadelphia, PA 19121-4739 | 2019-01-09 |
| 1831343789 | Temple University of The Commonwealth System of Higher Education | Clinic/Center | 1913 N Broad St, Philadelphia, PA 19122-6004 | 2008-11-05 |
| 1285622100 | Temple University of The Commonwealth System of Higher Education | Internal Medicine | 3322 N. Broad St., Philadelphia, PA 19140-5103 | 2005-10-13 |
| 1811985732 | Temple University of The Commonwealth System of Higher Education | Family Medicine | 1316 W. Ontario St., Philadelphia, PA 19140 | 2005-10-13 |
| 1245228360 | Temple University of The Commonwealth System of Higher Education | Psychologist | 100 E Lehigh Ave Bldg Ste 105, Philadelphia, PA 19125-1012 | 2005-10-12 |
| 1538157656 | Temple University of The Commonwealth System of Higher Education | Psychiatry & Neurology | 100 E Lehigh Ave Bldg Suite105, Philadelphia, PA 19125-1012 | 2005-10-12 |
| 1912995424 | Temple University of The Commonwealth System of Higher Education | Clinic/Center | 2450 W Hunting Park Ave, Philadelphia, PA 19129-1302 | 2005-10-10 |
| 1932197563 | Temple University of The Commonwealth System of Higher Education | Orthopaedic Surgery | Route 73 N, One Greentree Center, Marlton, NJ 08053 | 2005-10-07 |
| 1306833132 | Temple University of The Commonwealth System of Higher Education | Orthopaedic Surgery | 7604 Central Ave, Philadelphia, PA 19111-2433 | 2005-10-06 |
| 1841287695 | Temple University of The Commonwealth System of Higher Education | Physical Therapist | Route 73, One Greentree Center, Marlton, NJ 08053 | 2005-10-05 |
| Street Address |
3509 N BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19140-4105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669466793 | Riyaz Bashir | Internal Medicine | 3509 N Broad St, Philadelphia, PA 19140-5103 | 2005-09-05 |
| 1750841151 | Chloe Beiler | Physician Assistant | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2019-03-21 |
| 1770068041 | Chirantan Vinodbhai Mangukia | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-10-02 |
| 1891278933 | Temple Faculty Practice Plan, Inc | Speech-Language Pathologist | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-14 |
| 1396228508 | Temple Faculty Practice Plan, Inc | Surgery | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-13 |
| 1992288112 | Temple Faculty Practice Plan, Inc | Urology | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-13 |
| 1023591781 | Temple Faculty Practice Plan, Inc | Otolaryngology | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| 1154804839 | Temple Faculty Practice Plan, Inc | Physical Therapist | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| 1902389646 | Temple Faculty Practice Plan, Inc | Neurological Surgery | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| 1245713908 | Temple Faculty Practice Plan, Inc | Orthopaedic Surgery | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640519 | Desirea Grant | Registered Nurse | 2000 W. Venango Street, Phila, PA 19140 | 2020-08-19 |
| 1306316104 | Carmen Doumit | Dentist | 3223 N Broad Street, Temple University Department of Orthodontics, Philadelphia, PA 19140 | 2018-12-05 |
| 1780150375 | Samantha Marina Felix | Counselor | 3803-3805 N 5th St, Philadelphia, PA 19140 | 2018-10-22 |
| 1518485135 | Holly Marie Barbee | Dietitian, Registered | 4417 N 6th St., Philadelphia, PA 19140 | 2017-09-04 |
| 1033630892 | Jessica Anne Tang | Otolaryngology | 3440 North Broad Street, Kresge West #300, Philadelphia, PA 19140 | 2017-07-03 |
| 1710416870 | Narsis Aminian | Internal Medicine | 3401 N Broad Street, Temple Hospital, Neurlogy Deartment, Philadelphia, PA 19140 | 2017-06-12 |
| 1629527338 | Alaa Khatib | Pharmacist | 4616-4650 N. Broad Street, Philadelphia, PA 19140 | 2016-09-23 |
| 1548716160 | Direct Home Health Care | In Home Supportive Care | 3550 N 9th St, Philadelphia, PA 19140 | 2016-09-01 |
| 1306399225 | Zaima Choudhry | Student in an Organized Health Care Education/Training Program | Department of Pulmonary and Sleep Medicine, 3401 North Broad Street, Zone C - 7th Floor, Philadelphia, PA 19140 | 2016-07-27 |
| 1891145504 | Saji Mathew | Pharmacist | 4530n 5th Street, Philadelphia, PA 19140 | 2016-06-14 |
| Find all providers in zip 19140 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1003475120 | Michael Bradley Avery | Neurological Surgery | 909 Walnut Street, 2nd Floor, Philadelphia, PA 19107-5211 | 2019-06-12 |
| 1225370869 | Endrit Ziu | Neurological Surgery | 929 N 29th St, Apt 103, Philadelphia, PA 19130-1110 | 2013-03-21 |
| 1760617054 | Gentian Toshkezi | Neurological Surgery | 3998 Red Lion Rd Ste 213, Philadelphia, PA 19114 | 2009-05-15 |
| 1295900942 | Zarina S Ali | Neurological Surgery | 3400 Spruce Street Hup - Dept of Neurosurgery, 3 Silverstein, Philadelphia, PA 19104 | 2008-04-24 |
| 1629286018 | Stavropoula Ioannis Tjoumakaris | Neurological Surgery | 909 Walnut Street, 2rd Floor, Jefferson Neurosurgical Associates, Philadelphia, PA 19107-5211 | 2007-05-18 |
| 1639299837 | Neurosurgical Associates | Neurological Surgery | 5049 Oxford Ave, Philadelphia, PA 19124-2652 | 2007-03-30 |
| 1801910310 | Merylee Elizabeth Werthan | Neurological Surgery | 5049 Oxford Avenue, Philadelphia, PA 19124-2652 | 2007-03-19 |
| 1629132006 | Srinivas Kasinadhuni Prasad | Neurological Surgery | 909 Walnut St Fl 2, Philadelphia, PA 19107-5211 | 2006-12-20 |
| 1255403747 | Silva Markovic-plese | Neurological Surgery | 900 Walnut St Fl 2, Philadelphia, PA 19107-5509 | 2006-11-14 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19140 |
Please comment or provide details below to improve the information on TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.