NPIMap

Organization Active NPI

Temple Faculty Practice Plan Inc

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1174005011
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
TEMPLE FACULTY PRACTICE PLAN INC
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-3133
Fax
(215) 707-3945
NPI assigned
Sep 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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

Authorized official

Name
Tonya Woodard
Title
Director Revenue Cycle
Phone
(218) 707-3911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-3133

Other practice location 1

515 Pennsylvania Ave
Fort Washington, PA 19034-3314
Phone (215) 641-0700

Other practice location 2

701 Ostrum St
Bethlehem, PA 18015-1119
Phone (215) 707-3133

Other practice location 3

100 E Lehigh Ave
Philadelphia, PA 19125-1012
Phone (215) 707-3626

Other practice location 4

7500 Central Ave
Philadelphia, PA 19111-2430
Phone (215) 214-4100

Other names 1

  • Temple Faculty General Surgery Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190208002623 PA Part B Supplier - Clinic/Group Practice 0345588711 Receives reassigned benefits from 2,095 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

3509 N Broad St
Philadelphia, PA 19140
Phone (215) 707-2433

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536192000000",
    "number": "1174005011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-3133",
            "fax_number": "215-707-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3133",
            "fax_number": "215-707-3945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Washington",
            "state": "PA",
            "postal_code": "190343314",
            "country_code": "US",
            "telephone_number": "215-641-0700",
            "fax_number": "215-641-0637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Ostrum St",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180151119",
            "country_code": "US",
            "telephone_number": "215-707-3133",
            "fax_number": "215-707-3945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 E Lehigh Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191251012",
            "country_code": "US",
            "telephone_number": "215-707-3626",
            "fax_number": "215-707-8500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7500 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191112430",
            "country_code": "US",
            "telephone_number": "215-214-4100",
            "fax_number": "215-214-4124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEMPLE FACULTY PRACTICE PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-06",
        "last_updated": "2018-09-06",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE",
        "authorized_official_telephone_number": "218-707-3911"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temple Faculty General Surgery Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.