Individual provider Active NPI

Jordan Benjamin Rapp, M.D.

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1053679902
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD461409 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140
Phone
(215) 707-7237
Fax
(215) 707-9389
NPI assigned
Apr 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X MT205152 PA
Diagnostic Radiology Physician 2085R0202X 25MA10104300 NJ
Diagnostic Radiology Physician 2085R0202X MD461409 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-7237

Other practice location 1

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-2000

Other practice location 2

333 Cottman Ave
Philadelphia, PA 19111-2497
Phone (215) 728-3883

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
I20171011000117 PA Practitioner - Diagnostic Radiology 8628343076 Reassigns benefits to 5 organizations
I20181213000196 NJ Practitioner - Diagnostic Radiology 8628343076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Children'S Hospital, IncGroup PAC ID 0345154399, 40 clinicians

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (267) 425-9505

Hospital & facility affiliations

  • Children'S Hospital of Philadelphia Hospital, Philadelphia, PA, CCN 393303

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT205152PAMDPediatric Radiology Physician
25MA10104300NJMDDiagnostic Radiology Physician
MD461409PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HR Physician Services CurrentSince Feb 1, 2019 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2019 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Mar 6, 2019 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince May 1, 2019 Accepting new patients
Geisinger Clinic Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince May 1, 2019 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 6, 2019 Accepting new patients
University of Penn-Medical Group Pediatric Radiology CurrentSince May 1, 2019 Accepting new patients
Radiology Affiliates of Central New Jersey PC Pediatric Radiology CurrentSince Jun 1, 2018 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince May 1, 2019 Accepting new patients
Imaging Group of Delaware, PA Diagnostic Radiology Past Accepting new patients

Locations

3120 Princeton Pike
Lawrenceville, NJ 08648
Phone (570) 558-6858

2501 Kuser Rd
Trenton, NJ 08691
Phone (609) 587-4777

601 Hamilton Ave
Trenton, NJ 08629
Phone (609) 599-5000

100 N Academy Ave
Danville, PA 17822

2365 Heritage Center Dr
Furlong, PA 18925
Phone (215) 728-3883

1648 Huntingdon Pike
Meadowbrook, PA 19046
Phone (215) 938-3413

1650 Huntingdon Pike
Ste 160
Meadowbrook, PA 19046
Phone (215) 344-9560

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

5800 Ridge Ave
Philadelphia, PA 19128
Phone (215) 487-4334

1840 South St
Ste 3
Philadelphia, PA 19146
Phone (215) 546-1893

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

2301 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 282-8000

11000 Roosevelt Blvd
Philadelphia, PA 19116
Phone (215) 214-6655

701 E Marshall St
West Chester, PA 19380
Phone (610) 431-5000

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 6

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": "1335657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1053679902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-7237",
            "fax_number": "215-707-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "215-707-7237",
            "fax_number": "215-707-9389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405103",
            "country_code": "US",
            "telephone_number": "215-707-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 Cottman Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191112497",
            "country_code": "US",
            "telephone_number": "215-728-3883",
            "fax_number": "215-728-1185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAPP",
        "first_name": "JORDAN",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-29",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "PA",
            "license": "MT205152",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA10104300",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD461409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.