JEFFERSON UNIVERSITY PHYSICIANS (NPI# 1467626689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467626689 |
| Entity Type | Organization |
| Organization Name | JEFFERSON UNIVERSITY PHYSICIANS |
| Other Organization Name | RADIOLOGY |
| Practice Address |
111 S 11th St Ste G3390 Philadelphia PA 19107-4824 |
| Mailing Address |
833 Chestnut St Suite 680 Philadelphia PA 19107-4414 |
| Practice Telephone | 2159552900 |
| Mailing Telephone | 2159550800 |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2020-03-16 |
| Authorized Official Name | VALERIE BRIGHT-BUTLER (ASSOCIATE DIRECTOR) |
| Authorized Official Telephone | 2159559457 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | AETNA | 2542 | 01 |
| NJ | 7539002 | 05 | |
| PA | KEYSTONE MERCY | 33134 | 01 |
| PA | INDEPENDENCE BLUE CROSS | 0562328000 | 01 |
| PA | HIGHMARK BLUE SHIELD | 656588 | 01 |
| Other Name | Type Code |
|---|---|
| Radiology | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 833 Chestnut St, Suite 680, Philadelphia, PA 191074414 | 2159550800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487819900 | Jefferson University Physicians | Special Hospital | 900 Walnut Street, Jefferson Hospital for Neuroscience, Philadelphia, PA 19107 | 2008-07-24 |
| 1952860975 | Jefferson University Physicians | Allergy & Immunology | 1015 Chestnut St Ste 1300, Philadelphia, PA 19107-4313 | 2019-03-19 |
| 1306333695 | Jefferson University Physicians | Obstetrics & Gynecology | 833 Chestnut St Frnt 1, Philadelphia, PA 19107-4420 | 2018-04-23 |
| 1033564315 | Jefferson University Physicians | Dentist | 833 Chestnut St, Suite 630, Philadelphia, PA 19107-4414 | 2016-04-25 |
| 1487030763 | Jefferson University Physicians | Internal Medicine | 4735 Ogletown Stanton Rd, Newark, DE 19713-2072 | 2015-08-10 |
| 1609250604 | Jefferson University Physicians | Internal Medicine | 833 Chestnut St, Suite 630, Philadelphia, PA 19107-4414 | 2015-07-20 |
| 1376932616 | Jefferson University Physicians | Internal Medicine | 225 E City Ave, Suite 109, Bala Cynwyd, PA 19004-1704 | 2015-01-09 |
| 1407270903 | Jefferson University Physicians | Internal Medicine | 834 Walnut St, Suite 110, Philadelphia, PA 19107-5109 | 2014-02-05 |
| 1932449717 | Jefferson University Physicians | Internal Medicine | 925 Chestnut St Ste 420, Philadelphia, PA 19107-4216 | 2013-02-15 |
| 1437425360 | Jefferson University Physicians | Nutritionist | 615 Chestnut St, 14th Floor, Philadelphia, PA 19106-4495 | 2012-03-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Jefferson University Physicians | 100 College Building 1025 Walnut Street, Philadelphia, Pennsylvania 19107 |
| Street Address |
111 S 11TH ST STE G3390 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-4824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063067635 | Jefferson University Radiology Associates, LLC | Radiology | 3 Crescent Dr Ste 1002, Philadelphia, PA 19112-1016 | 2019-08-09 |
| 1033649975 | Dinh-huy Do Nguyen | Radiology | 5501 Old York Rd Ste 363, Philadelphia, PA 19141-3018 | 2017-06-13 |
| 1467809418 | Jeffrey Burgess | Radiology | 1215 Spruce St Apt 201, Philadelphia, PA 19107-5620 | 2016-05-19 |
| 1649632399 | Myron Blumberg | Radiology | 317 S 22nd St, Philadelphia, PA 19103-6528 | 2016-03-22 |
| 1144633074 | Daniel Robert Wahl | Radiology | 3400 Spruce Street - 1 Silverstein, Department of Radiology / Abdominal Imaging, Philadelphia, PA 19104 | 2014-06-09 |
| 1235564337 | Ron Benjamin | Radiology | 2055 E Fletcher St, Philadelphia, PA 19125 | 2013-09-08 |
| 1831454867 | Ryan Michael Bonshock | Radiology | 4220 Market St Fl 2, Philadelphia, PA 19104-3007 | 2012-07-05 |
| 1730498601 | Robert A Perkins Jr. | Radiology | 132 S 10th St Ste 1099j, Philadelphia, PA 19107-5244 | 2010-09-27 |
| 1457677007 | Michael Richard Acord | Radiology | 3401 Civic Blvd, Division of Radiology, Philadelphia, PA 19104 | 2010-04-07 |
| 1780918375 | Mollie Mcginley | Radiology | 1835 Arch St, Apartment 305, Philadelphia, PA 19103-2712 | 2009-09-29 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
Please comment or provide details below to improve the information on JEFFERSON UNIVERSITY PHYSICIANS.
| 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.