Individual provider Active NPI

Jonathan M Spergel, M.D.

  • Pediatric Allergy/Immunology Physician
  • Philadelphia, PA
National Provider Identifier
1043226996
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
MD065920L Issued in PA
Practice address
3550 Market St FL 3
Children's Hospital of Philadelphia - Allergy & Immun
Philadelphia, PA 19104-3365
Phone
(215) 590-2549
Fax
(215) 590-4529
NPI assigned
Jul 31, 2006
Last updated
Apr 15, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology (Internal Medicine) Physician 207RA0201X MD065920L PA
Allergy & Immunology (Internal Medicine) Physician 207RA0201X 25MA06906100 NJ
Pediatrics Physician 208000000X MD065920L PA
Pediatrics Physician 208000000X 25MA06906100 NJ
Pediatric Allergy/Immunology Physician 2080P0201X MD065920L PA Primary
Pediatric Allergy/Immunology Physician 2080P0201X 25MA06906100 NJ

Addresses

Primary practice location

3550 Market St FL 3
Children's Hospital of Philadelphia - Allergy & Immun
Philadelphia, PA 19104-3365

Mailing address

100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9232

Other identifiers 2

IdentifierTypeStateIssuer
7684908MedicaidNJ
001699833MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090130000540 PA Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 7719041078 Reassigns benefits to 1 organization
I20120328000188 NJ Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 7719041078 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06906100NJMDPediatric Allergy/Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates of New Jersey PC Pediatrics Current Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Feb 24, 2012 Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childen's Health Care Associates Inc. CurrentSince Feb 24, 2012 Accepting new patients
Childrens Health Care Associates, Inc Pediatric Allergy/Immunology CurrentSince Feb 24, 2012 Accepting new patients

Locations

1 Plainsboro Rd
Plainsboro, NJ 08536
Phone (609) 853-7000

101 Plainsboro Rd
Plainsboro, NJ 08536
Phone (267) 425-9505

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

100 N 20th St
Ste 301
Philadelphia, PA 19103
Phone (215) 561-0959

3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169

3550 Market St
Fl 3
Philadelphia, PA 19104
Phone (215) 590-2549

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1043226996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9232",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 MARKET ST FL 3",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA - ALLERGY & IMMUN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043365",
            "telephone_number": "215-590-2549",
            "fax_number": "215-590-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERGEL",
        "first_name": "JONATHAN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "PA",
            "license": "MD065920L",
            "primary": false
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "NJ",
            "license": "25MA06906100",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD065920L",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06906100",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "PA",
            "license": "MD065920L",
            "primary": true
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "NJ",
            "license": "25MA06906100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7684908",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001699833",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.