Organization Active NPI

Mercy Management of Sepa

Doing business as MMS-John Fobia, MD

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1245216308
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MERCY MANAGEMENT OF SEPA
Doing business as
MMS-John Fobia, MD
Practice address
501 S 54TH St
Suite 227
Philadelphia, PA 19143-1900
Phone
(215) 748-9653
Fax
(215) 748-9667
NPI assigned
Dec 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Authorized official

Name
Mr. Douglas C Smith
Title
VP Financial Services
Phone
(610) 567-6964

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

501 S 54TH St
Suite 227
Philadelphia, PA 19143-1900

Mailing address

1 W Elm St
2ND Floor
Conshohocken, PA 19428-2007
Phone (610) 567-6964

Other identifiers 6

IdentifierTypeStateIssuer
2229022000OtherPAKEYSTONE HEALTH PLAN EAST
2610916OtherPAAETNA HMO
30011086OtherPAKEYSTONE MERCY
BLUE SHIELDOtherPA1544375
1007787930158MedicaidPA
4100588OtherPAAETNA PPO

Other names 1

  • MMS-John Fobia, MD Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1245216308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "address_2": "2ND FLOOR",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282007",
            "telephone_number": "610-567-6964",
            "fax_number": "610-567-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 54TH ST",
            "address_2": "SUITE 227",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431900",
            "telephone_number": "215-748-9653",
            "fax_number": "215-748-9667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MANAGEMENT OF SEPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-21",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP FINANCIAL SERVICES",
        "authorized_official_telephone_number": "610-567-6964",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "2229022000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2610916",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30011086",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1544375",
            "identifier": "BLUE SHIELD",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007787930158",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4100588",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMS-John Fobia, MD",
            "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 Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.