Individual provider Active NPI

Colin Michael Kulick-Soper

  • Student in an Organized Health Care Education/Training Program
  • Philadelphia, PA
National Provider Identifier
1124778808
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
800 Spruce St
Philadelphia, PA 19107-6192
Phone
(215) 829-3309
Fax
(215) 829-7129
NPI assigned
Mar 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

800 Spruce St
Philadelphia, PA 19107-6192

Mailing address

800 Spruce St
Philadelphia, PA 19107-6192
Phone (215) 829-3309

Other names 1

  • Colin Michael Soper Former name

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
I20250722003620 PA Practitioner - Internal Medicine 0941716328 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of the University of PennsylvaniaGroup PAC ID 2062326507, 150 clinicians

Practice addresses (Care Compare)

700 Spruce St
Philadelphia, PA 19106-4098
Phone (215) 829-3521

700 Spruce St
Suite 304J
Philadelphia, PA 19106-4023
Phone (215) 829-3521

Hospital & facility affiliations

  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 1, 2025 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 1, 2025 Accepting new patients
Trustees of the University of Pennsylvania CurrentSince Jul 1, 2025 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Past Accepting new patients
The Pennsylvania Hospital of the University of Pennsylvania Health Sys Past Accepting new patients

Locations

700 Spruce St
Ste 304
Philadelphia, PA 19106
Phone (215) 829-3521

800 Spruce St
#1W
Philadelphia, PA 19107
Phone (215) 829-7817

3701 Market St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-2250

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

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 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": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1124778808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076192",
            "telephone_number": "215-829-3309",
            "fax_number": "215-829-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076192",
            "telephone_number": "215-829-3309",
            "fax_number": "215-829-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULICK-SOPER",
        "first_name": "COLIN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLIN",
            "last_name": "SOPER",
            "middle_name": "MICHAEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.