Active NPI
Steven Joel Nussbaum, MD
- Gastroenterology Physician
- West Chester, PA
National Provider Identifier
1114963345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MDV002383
- Practice address
- 300B Lawrence Dr
West Chester, PA 19380-4289 - Phone
- (610) 836-5990
- Fax
- (610) 836-5998
- NPI assigned
- Jun 22, 2006
- 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | MDV002383 | PA | Primary |
Addresses
Primary practice location
300B Lawrence Dr
West Chester, PA 19380-4289
Mailing address
409 Minden Way
Wynnewood, PA 19096-2323
Phone (610) 246-7152
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 078330602 | Medicaid | PA |
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 |
|---|---|---|---|
| MDV002383 | PA | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672531200000",
"number": "1114963345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 MINDEN WAY",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190962323",
"telephone_number": "610-246-7152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300B LAWRENCE DR",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193804289",
"telephone_number": "610-836-5990",
"fax_number": "610-836-5998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUSSBAUM",
"first_name": "STEVEN",
"middle_name": "JOEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2023-01-01",
"certification_date": "2023-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "PA",
"license": "MDV002383",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "078330602",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Chester, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.