Individual provider Active NPI

Jose Mario Quinonez, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1083174387
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD477757 Issued in PA
Practice address
51 N 39TH Street
PPMC, Department of Medicine
Philadelphia, PA 19104
Phone
(215) 662-8989
Fax
(215) 662-8989
NPI assigned
Mar 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD477757 PA Primary

Addresses

Primary practice location

51 N 39TH Street
PPMC, Department of Medicine
Philadelphia, PA 19104

Mailing address

51 N 39TH Street
PPMC, Department of Medicine
Philadelphia, PA 19104
Phone (215) 662-8989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260620000010 PA Practitioner - Internal Medicine 8022496454

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Miami, LM Miller School of Medicine, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2218 E Fletcher St
Philadelphia, PA 19125-2506

3803 W Chester Pike
Suite 160
Newtown Square, PA 19073-2336

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD477757PAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1083174387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH STREET",
            "address_2": "PPMC, DEPARTMENT OF MEDICINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-8989",
            "fax_number": "215-662-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH STREET",
            "address_2": "PPMC, DEPARTMENT OF MEDICINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-8989",
            "fax_number": "215-662-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINONEZ",
        "first_name": "JOSE",
        "middle_name": "MARIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD477757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.