Individual provider Active NPI

Thomas J Coyle Jr., MD

  • Surgery Physician
  • Sellersville, PA
National Provider Identifier
1124028055
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD032315E Issued in PA
Practice address
915 Lawn Ave
Suite 203
Sellersville, PA 18960-1551
Phone
(215) 257-3697
Fax
(215) 453-3410
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD032315E PA Primary

Addresses

Primary practice location

915 Lawn Ave
Suite 203
Sellersville, PA 18960-1551

Mailing address

PO Box 1111
Harleysville, PA 19438-0907
Phone (215) 257-3697

Other identifiers 3

IdentifierTypeStateIssuer
0011363710001MedicaidPA
30051893OtherPAKEYSTONE MERCY
4307607OtherPAAETNA

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1124028055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1111",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194380907",
            "telephone_number": "215-257-3697",
            "fax_number": "215-453-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 LAWN AVE",
            "address_2": "SUITE 203",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189601551",
            "telephone_number": "215-257-3697",
            "fax_number": "215-453-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD032315E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011363710001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30051893",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4307607",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sellersville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.