Active NPI
Temple University of the Commonwealth System of Higher Education
- Emergency Medicine Physician
- Philadelphia, PA
National Provider Identifier
1194785006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
- Doing business as
- Temple Emergency Medical Associates
- Practice address
- 3401 N Broad Street
Temple University Hospital
Philadelphia, PA 19140 - Phone
- (215) 707-5030
- Fax
- (215) 707-3494
- NPI assigned
- Mar 24, 2006
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary |
Addresses
Primary practice location
3401 N Broad Street
Temple University Hospital
Philadelphia, PA 19140
Mailing address
2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-5030
Other practice location 1
7600 Central Ave
Philadelphia, PA 19111-2430
Phone (215) 707-5522
Other practice location 2
100 E Lehigh Ave
Philadelphia, PA 19125-1012
Phone (215) 707-1656
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007780130275 | Medicaid | PA | |
| 1007780130282 | Medicaid | PA | |
| 411562 | Other | PA | HIGHMARK BS |
| 0060265000 | Other | PA | INDEPENDENCE BC |
| 1007780130281 | Medicaid | PA |
Other names 1
- Temple Emergency Medical Associates
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529020800000",
"number": "1194785006",
"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": "215-707-5030",
"fax_number": "215-707-3494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 N BROAD STREET",
"address_2": "TEMPLE UNIVERSITY HOSPITAL",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19140",
"telephone_number": "215-707-5030",
"fax_number": "215-707-3494"
}
],
"practiceLocations": [
{
"address_1": "7600 Central Ave",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191112430",
"country_code": "US",
"telephone_number": "215-707-5522",
"fax_number": "215-707-5031",
"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": "215-707-1656",
"fax_number": "215-707-0805",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-24",
"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": "207P00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007780130275",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007780130282",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BS",
"identifier": "411562",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BC",
"identifier": "0060265000",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007780130281",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Temple Emergency Medical Associates",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Temple Emergency Medical Associates",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Philadelphia, PA
- Temple University of the Commonwealth System of Higher Education
- Temple University of the Commonwealth System of Higher Education
- Temple University of the Commonwealth System of Higher Education
- Temple University of the Commonwealth System of Higher Education
- Temple University of the Commonwealth System of Higher Education
- Temple University of the Commonwealth System of Higher Education
- Temple University of the Commonwealth System of Higher Education
- Temple University of the Commonwealth System of Higher Education
- Temple University of the Commonwealth System of Higher Education
- Temple University of the Commonwealth System of Higher Education
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.