ENT R Net, P a

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

OS001941L Issued in PA

Legal business name

ENT R NET, P A

Practice address

4190 City Ave
Suite 526
Philadelphia, PA 19131-1626

Phone

(215) 879-0060

Fax

(215) 879-0063

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Theodore Mauer, D.O.

Title

Owner

Phone

(215) 879-0060

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043255540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "address_2": "SUITE 526",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-879-0060",
            "fax_number": "215-879-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "address_2": "SUITE 526",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-879-0060",
            "fax_number": "215-879-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT R NET, P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAUER",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-879-0060",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "OS001941L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0170250000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "183919",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30723",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Enspirit Enterprises, LLC
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• Ensure Home Health Care Inc
• Ensure Medical Supplies LLC
• ENT R Net PA
• Kevin Enterlin
• Vahid Entezari, M.D. M.M.SC
• Brian V Entler, MD, MS
• Nyssa Entrekin, RD, LDN
• Hasan Daniel Entwistle, MD

• Otolaryngology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Otolaryngology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.

Verify at the official NPI Registry.