Individual provider Active NPI

Austin Robert Hale, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Philadelphia, PA
National Provider Identifier
1154989556
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
MD491255 Issued in PA
Practice address
909 Walnut St RM 300
Philadelphia, PA 19107-5211
Phone
(215) 503-6215
Fax
(215) 923-9189
NPI assigned
May 31, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS042265 PA
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X MD491255 PA Primary

Addresses

Primary practice location

909 Walnut St RM 300
Philadelphia, PA 19107-5211

Mailing address

909 Walnut St RM 300
Philadelphia, PA 19107-5211
Phone (215) 503-7118

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250702000880 PA Practitioner - Oral Surgery 3375879737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Columbia University College of Dental Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-4000

111 S 11TH St
Philadelphia, PA 19107-4824

3 Crescent Dr
Suite 100
Philadelphia, PA 19112-1016
Phone (215) 955-2392

834 Walnut St
Suite 110
Philadelphia, PA 19107-5109
Phone (215) 503-4779

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
  • Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS042265PAMDOral and Maxillofacial Surgery (Dentist)
MD491255PAMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Jul 1, 2025 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

10800 Knights Rd
Ste 125
Philadelphia, PA 19114
Phone (215) 904-1898

3 Crescent Dr
#4
Philadelphia, PA 19112

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

909 Walnut St
Rm 300
Philadelphia, PA 19107
Phone (215) 503-6215

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 2

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 2

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": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1154989556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 WALNUT ST RM 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075211",
            "telephone_number": "215-503-7118",
            "fax_number": "215-923-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 WALNUT ST RM 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075211",
            "telephone_number": "215-503-6215",
            "fax_number": "215-923-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "AUSTIN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-31",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS042265",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PA",
            "license": "MD491255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.