Individual provider Active NPI

John W. Caruso, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1003834235
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-053088-L Issued in PA
Practice address
833 Chestnut St
Suite 220
Philadelphia, PA 19107-4414
Phone
(215) 955-8465
Fax
(215) 955-2516
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD-053088-L PA Primary

Addresses

Primary practice location

833 Chestnut St
Suite 220
Philadelphia, PA 19107-4414

Mailing address

833 Chestnut St
Suite 220
Philadelphia, PA 19107-4414

Other identifiers 2

IdentifierTypeStateIssuer
001528148MedicaidPA
7709901MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050126000894 PA Practitioner - Internal Medicine 8628028727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

33 S 9TH Street 3Rd Floor
Jefferson Rehabilitation Medicine
Philadelphia, PA 19107-4414
Phone (215) 955-7190

833 Chestnut St
Suite 138
Philadelphia, PA 19107-4414
Phone (888) 855-6649

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-053088-LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Internal Medicine CurrentSince Sep 1, 1995 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

833 Chestnut St
Ste 701
Philadelphia, PA 19107
Phone (215) 955-0735

833 Chestnut St
Ste 220
Philadelphia, PA 19107
Phone (215) 955-2363

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Networks

  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1003834235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "SUITE 220",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "SUITE 220",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414",
            "telephone_number": "215-955-8465",
            "fax_number": "215-955-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARUSO",
        "first_name": "JOHN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD-053088-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001528148",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7709901",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.