Active NPI
David John Dzurinko, MD
- Obstetrics & Gynecology Physician
- Philadelphia, PA
National Provider Identifier
1083691968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD 026315E
- Practice address
- 3401 N Broad St
7TH Floor Out Patient Building
Philadelphia, PA 19140-5103 - Phone
- (215) 707-3008
- Fax
- (215) 707-1387
- NPI assigned
- Dec 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD 026315E | PA | Primary |
Addresses
Primary practice location
3401 N Broad St
7TH Floor Out Patient Building
Philadelphia, PA 19140-5103
Mailing address
2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-8561
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001196692 | Medicaid | PA | |
| 160052548 | Other | PA | RR MEDICARE |
| 0052792000 | Other | PA | INDEPENDENCE BLUE CROSS |
| 065674 | Other | PA | HIGHMARK BLUE SHIELD |
| 1578942 | Other | PA | AETNA HMO |
| 30040344 | Other | PA | KKMHP |
| 4414790 | Other | PA | AETNA PPO |
| 30038165 | Other | PA | KMHP |
| 3Y2472 | Other | PA | HEALTH NET |
| 597586 | Other | PA | MEDICARE GROUP |
| 2910 | Other | PA | BRAVO HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD 026315E | PA | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489017600000",
"number": "1083691968",
"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": "215-707-8561",
"fax_number": "215-707-3677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 N BROAD ST",
"address_2": "7TH FLOOR OUT PATIENT BUILDING",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405103",
"telephone_number": "215-707-3008",
"fax_number": "215-707-1387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DZURINKO",
"first_name": "DAVID",
"middle_name": "JOHN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-30",
"last_updated": "2017-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "PA",
"license": "MD 026315E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001196692",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "160052548",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BLUE CROSS",
"identifier": "0052792000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "065674",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "1578942",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KKMHP",
"identifier": "30040344",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4414790",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KMHP",
"identifier": "30038165",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "3Y2472",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "597586",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BRAVO HEALTH",
"identifier": "2910",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.