NPIMap

Individual provider Active NPI

William I Jaffe, MD

  • Urology Physician
  • Philadelphia, PA
National Provider Identifier
1124016225
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD419664 Issued in PA
Practice address
51 N 39TH St
Suite 300 Mob
Philadelphia, PA 19104-2640
Phone
(215) 662-8699
Fax
(215) 243-4649
NPI assigned
Oct 12, 2005
Last updated
Oct 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD419664 PA Primary

Addresses

Primary practice location

51 N 39TH St
Suite 300 Mob
Philadelphia, PA 19104-2640

Mailing address

51 N 39TH St
Suite 300 Mob
Philadelphia, PA 19104-2640
Phone (215) 662-8699

Other identifiers 1

IdentifierTypeStateIssuer
1013014400001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050606001118 PA Practitioner - Urology 1355309279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Perelman School of Med at the University of Pennsylvania, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127
Phone (215) 662-2891

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD419664PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group Urology CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Weill Medical College of Cornell Urology Past Accepting new patients
Bih Radiologic Foundation Inc Past Accepting new patients

Locations

333 E City Ave
Ste IL27
Bala Cynwyd, PA 19004
Phone (610) 664-5156

3400 Convention Ave
Philadelphia, PA 19104
Phone (215) 662-2300

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3737 Market St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-8664

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

800 Walnut St
Fl 19
Philadelphia, PA 19107
Phone (215) 829-3409

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

145 King of Prussia Rd
Ste 203
St Davids, PA 19087
Phone (215) 662-8664

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1124016225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "address_2": "SUITE 300 MOB",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-8699",
            "fax_number": "215-243-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "address_2": "SUITE 300 MOB",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-8699",
            "fax_number": "215-243-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFE",
        "first_name": "WILLIAM",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD419664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013014400001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.