Individual provider Active NPI

Kristin McCloskey, M.D.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1114288685
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT201897 Issued in PA
Practice address
230 N Broad St
Philadelphia, PA 19102-1121
Phone
(215) 762-2365
NPI assigned
May 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT201897 PA Primary

Addresses

Primary practice location

230 N Broad St
Philadelphia, PA 19102-1121

Mailing address

133 Poplar Ave
Wayne, PA 19087-3501
Phone (610) 574-1459

Other identifiers 1

IdentifierTypeStateIssuer
MT201897OtherPAMT LICENSE

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
I20160211001159 PA Practitioner - Emergency Medicine 0648574608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

60 E Township Line Rd
Tabor Emergency Physicians
Elkins Park, PA 19027-2220
Phone (215) 663-6323

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT201897PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc Current Accepting new patients
Drexel University CurrentSince Jan 3, 2016 Accepting new patients
Drexel University Current Accepting new patients
Einstein Practice Plan Inc CurrentSince Jul 10, 2017 Accepting new patients
Einstein Practice Plan, Inc CurrentSince Jul 10, 2017 Accepting new patients
Drexel University CurrentSince Jan 3, 2016 Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660

230 N Broad St
Philadelphia, PA 19102
Phone (215) 255-3828

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1114288685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 POPLAR AVE",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190873501",
            "telephone_number": "610-574-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-762-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLOSKEY",
        "first_name": "KRISTIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT201897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT LICENSE",
            "identifier": "MT201897",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.