Jeremy Kent Souder, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD432810 Issued in PA

Practice address

3400 Spruce St
1 Maloney Building
Philadelphia, PA 19104-4206

Phone

(215) 662-2200

NPI assigned

Dec 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Hospice/Palliative Care

Education

Perelman School of Med at the University of Pennsylvania, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinical Care Associates of the University of Pennsylvania Health.Group PAC ID 4688588866, 591 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Clinical Care Associates of the University of Pennsylvania Health

  • Internal Medicine Physician
  • Radnor, PA
  • NPI 1972682995
  Medicare reassignment Care Compare group NPD
• Clinical Care Associates of the University of Pennsylvania Health

  • Psychologist
  • West Chester, PA
  • NPI 1649940107
  NPD
• Clinical Care Associates of the University of Pennsylvania Health Syst

  • Hospitalist Physician
  • Bala Cynwyd, PA
  • NPI 1790737468

  Internal Medicine

  NPD
• Clinical Specialty Associates

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Bala Cynwyd, PA
  • NPI 1184431900
  NPD (past)
• The Pennsylvania Hospital of the University of Pennsylvania Health Sys

  • General Acute Care Hospital
  • Phila, PA
  • NPI 1063489342
  NPD (past)

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

• The Pennsylvania Hospital of the University of Pennsylvania Health Sys

  • General Acute Care Hospital
  • Phila, PA
  • NPI 1063489342
  Care Compare affiliation

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1225193543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "1 MALONEY BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "1 MALONEY BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUDER",
        "first_name": "JEREMY",
        "middle_name": "KENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT186304",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD432810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susana Soto
• Jason Alexander Sotomayor
• James Eliot Sottile, PHD
• Devon Soucier
• Emily Souder, M.D.
• Kathryn Souder, LCSW
• Beth Souders, BS, MS, CGC
• Margaret Cooney Souders, CRNP
• Ellie Souganidis, M.D.
• Addison Soukup, CNP

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.