NPIMap

Individual provider Active NPI

Gretchen Schaub, DO

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1063916054
Registry record updated Nov 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS022081 Issued in PA
Practice address
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone
(800) 879-2467
NPI assigned
Mar 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DO2948 NV
Pediatrics Physician 208000000X SL1310 NV
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X OS022081 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Mailing address

7516 Newland St
Philadelphia, PA 19128-4133
Phone (614) 915-1922

Other identifiers 1

IdentifierTypeStateIssuer
1063916054OtherNVINDIVIDUAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address schaubg@chop.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230915002470 PA Practitioner - Pediatric Medicine 0446508907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-1000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Childen's Health Care Associates Inc. CurrentSince Jul 12, 2023 Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc CurrentSince Jul 12, 2023 Accepting new patients
90 Cafferty Road Operating Company, LP Past Accepting new patients
Childrens Health Care Associates of New Jersey PC Pediatrics Past Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients

Locations

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

3401 Civic Center Blvd
#M975
Philadelphia, PA 19104

Interoperability endpoints

  • Direct secure messaging: gschaub90115@direct.umcsn.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669507200000",
    "number": "1063916054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7516 NEWLAND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191284133",
            "telephone_number": "614-915-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "800-879-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAUB",
        "first_name": "GRETCHEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2022-11-27",
        "certification_date": "2022-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "DO2948",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "SL1310",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS022081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "1063916054",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schaubg@chop.edu",
            "affiliation": "N",
            "address_1": "3401 Civic Center Blvd",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191044319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.