NPIMap

Organization Active NPI

Temple University of the Commonwealth System of Higher Education

  • Obstetrics & Gynecology Physician
  • Philadelphia, PA
National Provider Identifier
1194713073
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Doing business as
Temple Ob Gyn Associates
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-3008
Fax
(215) 707-1387
NPI assigned
Oct 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Authorized official

Name
Tonya Woodard
Title
Credentialing/Manager
Phone
(215) 707-3911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 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) 707-3008

Other practice location 1

7602 Central Ave
Philadelphia, PA 19111-2443
Phone (215) 745-8989

Other practice location 2

9331 Old Bustleton Ave
Philadelphia, PA 19115-4204
Phone (215) 602-8900

Other practice location 3

133 W Hunting Park Ave
Philadelphia, PA 19140-2717
Phone (215) 324-0600

Other practice location 4

1741 Frankford Ave
Philadelphia, PA 19125-2445
Phone (215) 425-2424

Other practice location 5

100 E Lehigh Ave
Philadelphia, PA 19125-1012
Phone (215) 707-1840

Other practice location 6

2301 E Allegheny Ave
Philadelphia, PA 19134-4427
Phone (215) 926-3700

Other practice location 7

525 Jamestown St
Philadelphia, PA 19128-1751
Phone (215) 783-3700

Other practice location 8

8815 Germantown Ave
Philadelphia, PA 19118-2722
Phone (215) 707-3008

Other practice location 9

515 Pennsylvania Ave
Fort Washington, PA 19034-3314
Phone (215) 707-3008

Other identifiers 10

IdentifierTypeStateIssuer
1007780130764MedicaidPA
1007780130787MedicaidPA
1007780130766MedicaidPA
1007780130832MedicaidPA
1007780130765MedicaidPA
1007780130069MedicaidPA
1007780130768MedicaidPA
1007780130767MedicaidPA
1007780130788MedicaidPA
1007780130798MedicaidPA

Other names 1

  • Temple Ob Gyn Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000333 PA Part B Supplier - Clinic/Group Practice 2961314299 Receives reassigned benefits from 19 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

7602 Central Ave
Philadelphia, PA 19111
Phone (215) 745-8989

133 W Hunting Park Ave
Philadelphia, PA 19140
Phone (215) 324-0600

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529020800000",
    "number": "1194713073",
    "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": "215-707-3008",
            "fax_number": "215-707-1387"
        },
        {
            "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": "215-707-3008",
            "fax_number": "215-707-1387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7602 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191112443",
            "country_code": "US",
            "telephone_number": "215-745-8989",
            "fax_number": "215-725-9072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9331 Old Bustleton Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191154204",
            "country_code": "US",
            "telephone_number": "215-602-8900",
            "fax_number": "215-602-8904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "133 W Hunting Park Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191402717",
            "country_code": "US",
            "telephone_number": "215-324-0600",
            "fax_number": "215-324-2795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1741 Frankford Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191252445",
            "country_code": "US",
            "telephone_number": "215-425-2424",
            "fax_number": "215-425-0346",
            "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": "215-707-1840",
            "fax_number": "215-707-8570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 E Allegheny Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191344427",
            "country_code": "US",
            "telephone_number": "215-926-3700",
            "fax_number": "215-926-3702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 Jamestown St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191281751",
            "country_code": "US",
            "telephone_number": "215-783-3700",
            "fax_number": "215-487-1251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8815 Germantown Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191182722",
            "country_code": "US",
            "telephone_number": "215-707-3008",
            "fax_number": "215-707-1387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Washington",
            "state": "PA",
            "postal_code": "190343314",
            "country_code": "US",
            "telephone_number": "215-707-3008",
            "fax_number": "215-707-1387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-13",
        "last_updated": "2018-06-15",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "CREDENTIALING/MANAGER",
        "authorized_official_telephone_number": "215-707-3911"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130764",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130787",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130766",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130832",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130765",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130069",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130768",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130767",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130788",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130798",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temple Ob Gyn Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Temple Ob Gyn 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 Jun 15, 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.