Individual provider Active NPI

Joy Lynn Collins, M.D.

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1255428819
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD066480L Issued in PA
Practice address
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone
(215) 590-2730
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X MD066480L PA
Pediatric Surgery Physician 2086S0120X 0101261340 VA
Surgery Physician 208600000X MD066480L PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Mailing address

102 Highland Ave SE Ste 404
Roanoke, VA 24013-2232
Phone (540) 985-9812

Other practice location 1

102 Highland Ave SE Ste 404
Roanoke, VA 24013-2232
Phone (540) 985-9812

Other identifiers 1

IdentifierTypeStateIssuer
101032781MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcollins88664@direct.carilionclinic.org Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040804000136 PA Practitioner - General Surgery 4880665728 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD066480LPAMDSurgery Physician
0101261340VAMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Surgical Associates LTD CurrentSince Oct 3, 2022 Accepting new patients
Children'S Surgical Associates LTD Current Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients
Children'S Surgical Associates LTD Surgery Past Accepting new patients
Children'S Surgical Associates of New Jersey Inc Surgery Past Accepting new patients

Locations

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169

Interoperability endpoints

  • Direct secure messaging: jcollins88664@direct.carilionclinic.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1255428819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HIGHLAND AVE SE STE 404",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240132232",
            "telephone_number": "540-985-9812",
            "fax_number": "540-985-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-2730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Highland Ave SE Ste 404",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240132232",
            "country_code": "US",
            "telephone_number": "540-985-9812",
            "fax_number": "540-985-5328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JOY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "PA",
            "license": "MD066480L",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "VA",
            "license": "0101261340",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD066480L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101032781",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcollins88664@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jcollins88664@direct.carilionclinic.org",
            "address_1": "102 Highland Ave SE Ste 404",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240132232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.