Organization Active NPI

Suburban Orthopaedics PC

  • Orthopaedic Surgery Physician
  • Langhorne, PA
National Provider Identifier
1043280316
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SUBURBAN ORTHOPAEDICS PC
Practice address
240 Middletown Blvd
Suite 101D
Langhorne, PA 19047-1832
Phone
(215) 750-6700
Fax
(215) 750-6706
NPI assigned
Jan 26, 2006
Last updated
Apr 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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

Authorized official

Name
John Petolillo Jr., DONPI 1780684084
Title
Owner
Phone
(215) 750-6700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

240 Middletown Blvd
Suite 101D
Langhorne, PA 19047-1832

Mailing address

240 Middletown Blvd
Suite 101D
Langhorne, PA 19047-1832
Phone (215) 750-6700

Other identifiers 2

IdentifierTypeStateIssuer
200044351OtherPATRAVELERS MEDICARE
989692OtherHIGHMARK BS

National Provider Directory

National Provider Directory

Locations

402 Middletown Blvd
Ste 216
Langhorne, PA 19047
Phone (215) 750-6700

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1043280316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MIDDLETOWN BLVD",
            "address_2": "SUITE 101D",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471832",
            "telephone_number": "215-750-6700",
            "fax_number": "215-750-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MIDDLETOWN BLVD",
            "address_2": "SUITE 101D",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471832",
            "telephone_number": "215-750-6700",
            "fax_number": "215-750-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN ORTHOPAEDICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "PETOLILLO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-750-6700",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "200044351",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS",
            "identifier": "989692",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Langhorne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; 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.