Active NPI
George Joseph Koenig Jr., D.O.
- Surgery Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- OS014781
- Practice address
- 1100 Walnut St
Suite 500
Philadelphia, PA 19107-5563 - Phone
- (215) 955-6750
- NPI assigned
- Mar 6, 2008
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | OT010389 | PA | |
| Surgery Physician | 208600000X | OS014781 | PA | Primary |
| Surgery Physician | 208600000X | H69369 | MD | |
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | H69369 | MD |
Addresses
Primary practice location
1100 Walnut St
Suite 500
Philadelphia, PA 19107-5563
Mailing address
1100 Walnut St
Suite 500
Philadelphia, PA 19107-5563
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102494600 | Medicaid | PA | |
| 023819800 | Medicaid | MD | |
| 0231724 | Medicaid | NJ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Philadelphia College of Osteopathic Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (610) 642-1908
925 Chestnut St
FL 6
Philadelphia, PA 19107-4204
Phone (215) 955-6760
Hospital & facility affiliations
- Thomas Jefferson University Hospital
- Main Line Hospital Lankenau
- Jefferson Abington Hospital
- Jefferson Stratford Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 28 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT010389 | PA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson University Physicians | Surgery | Current | Accepting new patients |
| Main Line Healthcare | Surgery | Current | Accepting new patients |
| Thomas Jefferson University Hospitals Inc | Past | Accepting new patients | |
| Jefferson University Physicians | Past | Accepting new patients | |
| Main Line Hospitals, Inc. | Past | Accepting new patients |
Locations
830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200
3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530
1100 Walnut St
Ste 500
Philadelphia, PA 19107
Phone (215) 955-6750
925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760
1100 Walnut St
Fl 5
Philadelphia, PA 19107
Phone (215) 955-6750
1101 Chestnut St
#8
Philadelphia, PA 19107
Phone (215) 955-5869
100 E Lancaster Ave
#275
Wynnewood, PA 19096
Phone (215) 622-3743
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.
-
- Gastroenterology Physician
- Phila, PA
- NPI 1205898723
-
- General Acute Care Hospital
- Wynnewood, PA
- NPI 1245335629
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1215916002
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Abington, PA
- NPI 1811992084
-
- General Acute Care Hospital
- Wynnewood, PA
- NPI 1245335629
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1215916002
-
- General Acute Care Hospital
- Stratford, NJ
- NPI 1386746592
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427241600000",
"number": "1144490004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 WALNUT ST",
"address_2": "SUITE 500",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WALNUT ST",
"address_2": "SUITE 500",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075563",
"telephone_number": "215-955-6750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENIG",
"first_name": "GEORGE",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-06",
"last_updated": "2015-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "OT010389",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "OS014781",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MD",
"license": "H69369",
"primary": false
},
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "MD",
"license": "H69369",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102494600",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "023819800",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0231724",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.