Active NPI
Usurg Associates Inc
- Urology Physician
- Broomall, PA
National Provider Identifier
1013000983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- MD030565L
- Legal business name
- USURG ASSOCIATES INC
- Practice address
- 1999 Sproul Rd
Suites 12 and 16
Broomall, PA 19008-3522 - Phone
- (610) 534-6100
- Fax
- (610) 534-6104
- NPI assigned
- Oct 2, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Michael Raezer, M.D.
- Title
- Physician/Owner
- Phone
- (610) 534-6100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD030565L | PA | Primary |
Addresses
Primary practice location
1999 Sproul Rd
Suites 12 and 16
Broomall, PA 19008-3522
Mailing address
1999 Sproul Rd
Suites 12 and 16
Broomall, PA 19008-3522
Phone (610) 534-6100
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0007379020002 | Medicaid | PA | |
| 0031122000 | Other | PA | KEYSTONE PROVIDER ID # |
| 0031122000 | Other | PA | AMERIHEALTH PROV ID # |
| P3615833 | Other | PA | MULTIPLAN PROVIDER ID # |
| 3537609 | Medicaid | NJ |
National Provider Directory
National Provider DirectoryLocations
1501 Lansdowne Ave
Ste 301
Darby, PA 19023
Phone (610) 586-5018
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1587513600000",
"number": "1013000983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1999 SPROUL RD",
"address_2": "SUITES 12 AND 16",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190083522",
"telephone_number": "610-534-6100",
"fax_number": "610-534-6104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1999 SPROUL RD",
"address_2": "SUITES 12 AND 16",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190083522",
"telephone_number": "610-534-6100",
"fax_number": "610-534-6104"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "USURG ASSOCIATES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-02",
"last_updated": "2020-04-22",
"certification_date": "2020-04-22",
"status": "A",
"authorized_official_last_name": "RAEZER",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "PHYSICIAN/OWNER",
"authorized_official_telephone_number": "610-534-6100",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": "PA",
"license": "MD030565L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0007379020002",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE PROVIDER ID #",
"identifier": "0031122000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH PROV ID #",
"identifier": "0031122000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN PROVIDER ID #",
"identifier": "P3615833",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3537609",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Broomall, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.