NPIMap

Individual provider Active NPI

Jack Allan, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1215598362
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD476370 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5189
Phone
(215) 707-2000
NPI assigned
Jun 27, 2019
Last updated
Jun 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD476370 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5189

Mailing address

1316 W Ontario St
Philadelphia, PA 19140-5220
Phone (804) 615-4332

Other practice location 1

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-1000

Other practice location 2

160 E Erie Ave
Philadelphia, PA 19134-1011
Phone (215) 427-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220609001713 PA Practitioner - Emergency Medicine 7214263540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Virginia Commonwealth University, School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

7600 Central Ave
Philadelphia, PA 19111-2442
Phone (215) 214-7875

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan, Inc CurrentSince Jul 1, 2022 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Jul 1, 2022 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients

Locations

1316 W Ontario St
Philadelphia, PA 19140
Phone (215) 707-2400

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1215598362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 W ONTARIO ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405220",
            "telephone_number": "804-615-4332"
        },
        {
            "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": "191405189",
            "telephone_number": "215-707-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Civic Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "215-590-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 E Erie Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191341011",
            "country_code": "US",
            "telephone_number": "215-427-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLAN",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD476370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.