Active NPI
Judith Ann Tanenbaum, PAC
- Physician Assistant
- Phila, PA
National Provider Identifier
1184601627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA002088L
- Practice address
- 2100 W Girard Ave
Phila, PA 19130 - Phone
- (215) 214-1094
- Fax
- (215) 214-1098
- NPI assigned
- Dec 27, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA002088L | PA | Primary |
Addresses
Primary practice location
2100 W Girard Ave
Phila, PA 19130
Mailing address
623 Unruh Ave
2ND FL
Phila, PA 19111
Phone (215) 214-1094
Other names 1
- Judith Ann Levine
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA002088L | PA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1184601627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 UNRUH AVE",
"address_2": "2ND FL",
"city": "PHILA",
"state": "PA",
"postal_code": "19111",
"telephone_number": "215-214-1094",
"fax_number": "215-214-1098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 W GIRARD AVE",
"city": "PHILA",
"state": "PA",
"postal_code": "19130",
"telephone_number": "215-214-1094",
"fax_number": "215-214-1098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANENBAUM",
"first_name": "JUDITH",
"middle_name": "ANN",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-27",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA002088L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JUDITH",
"last_name": "LEVINE",
"middle_name": "ANN",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Phila, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.