Active NPI
Douglas S Cosgrove, MD
- Psychiatry Physician
- Philadelphia, PA
National Provider Identifier
1164468427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD044861L
- Practice address
- 101 E Olney Ave
Suite 400
Philadelphia, PA 19120-2421 - Phone
- (215) 456-7000
- Fax
- (215) 254-2599
- NPI assigned
- Jun 22, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD044861L | PA | Primary |
Addresses
Primary practice location
101 E Olney Ave
Suite 400
Philadelphia, PA 19120-2421
Mailing address
4200 Monument Rd
Philadelphia, PA 19131-1625
Phone (215) 581-3763
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD044861L | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285027200000",
"number": "1164468427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 MONUMENT RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191311625",
"telephone_number": "215-581-3763",
"fax_number": "215-254-2599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 E OLNEY AVE",
"address_2": "SUITE 400",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191202421",
"telephone_number": "215-456-7000",
"fax_number": "215-254-2599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSGROVE",
"first_name": "DOUGLAS",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2010-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD044861L",
"primary": true
}
],
"identifiers": [],
"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 Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.