Individual provider Active NPI

Neil M Cohen, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1114980356
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS003689L Issued in PA
Practice address
12000 Bustleton Ave
Suite 102
Philadelphia, PA 19116-2151
Phone
(215) 673-7600
Fax
(215) 673-1894
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS003689L PA Primary

Addresses

Primary practice location

12000 Bustleton Ave
Suite 102
Philadelphia, PA 19116-2151

Mailing address

2450 W Hunting Park Ave
2ND Floor Tpi-Cbo
Philadelphia, PA 19129-1302
Phone (215) 926-9000

Other identifiers 1

IdentifierTypeStateIssuer
0006962920001MedicaidPA

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
I20100929001190 PA Practitioner - Family Practice 5395861181 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physician Inc. CurrentSince May 1, 2015 Accepting new patients
Temple Physicians Inc Family Medicine Current Accepting new patients
Temple Physicians Inc CurrentSince May 1, 2015 Accepting new patients
Temple Physicians Inc Family Medicine Past Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

12000 Bustleton Ave
Ste 102
Philadelphia, PA 19116
Phone (215) 673-7600

Organizations & group practices 4

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1114980356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "address_2": "2ND FLOOR TPI-CBO",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-926-9000",
            "fax_number": "215-226-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 BUSTLETON AVE",
            "address_2": "SUITE 102",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162151",
            "telephone_number": "215-673-7600",
            "fax_number": "215-673-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "NEIL",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS003689L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006962920001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.