Individual provider Active NPI

Michael A Becker, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1265403349
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS006490L Issued in PA
Practice address
4190 City Ave
Philadelphia, PA 19131-1626
Phone
(215) 871-6380
Fax
(215) 871-6381
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS006490L PA Primary

Addresses

Primary practice location

4190 City Ave
Philadelphia, PA 19131-1626

Mailing address

4190 City Ave
Philadelphia, PA 19131-1626
Phone (215) 871-6380

Other identifiers 10

IdentifierTypeStateIssuer
461861OtherPAAUSHC HMO
P3063930OtherPAOXFORD
5638486-008OtherPACIGNA
100138OtherPAKMHP
85753OtherPAAUSHC PPO
0012483040007MedicaidPA
01248304-05OtherPAAMERICHOICE
0457700000OtherPAKHPE
627939OtherPAHIGHMARK BLUE SHIELD
34238OS006490LOtherPAHEALTHPARTNERS

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
I20090406000266 PA Practitioner - Family Practice 2769539915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Philadelphia College of Osteopathic MedicineGroup PAC ID 0648179234, 30 clinicians

Practice addresses (Care Compare)

4190 City Ave
Suite 315
Philadelphia, PA 19131-1633
Phone (215) 871-6384

4190 City Line Ave
Philadelphia, PA 19131-1626

4190 City Line Ave
Philadelphia, PA 19131-1633

Merit-based Incentive Payment System (MIPS)

Final score
79.67 of 100Reported as group
Quality
69.85
Promoting interoperability
54
Improvement activities
40
Cost
75.17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Philadelphia College of Osteopathic Medicine Family Medicine CurrentSince Jun 1, 2010 Accepting new patients
Philadelphia College of Osteopathic Medicine Past Accepting new patients
Mercy Suburban Hospital Family Medicine Past Accepting new patients

Locations

4190 City Line Ave
Ste 315
Philadelphia, PA 19131
Phone (215) 871-6337

4148 Lancaster Ave
Philadelphia, PA 19104
Phone (215) 662-0119

2100 W Cambria St
Philadelphia, PA 19132
Phone (215) 578-3300

4190 City Line Ave
Ste 777
Philadelphia, PA 19131
Phone (215) 871-6380

4190 City Line Ave
Philadelphia, PA 19131
Phone (215) 871-6100

4190 City Line Ave
Ste 100
Philadelphia, PA 19131
Phone (215) 871-6380

Interoperability endpoints

  • Direct secure messaging: michael.becker@direct.pcom.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1265403349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-871-6380",
            "fax_number": "215-871-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-871-6380",
            "fax_number": "215-871-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006490L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUSHC HMO",
            "identifier": "461861",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3063930",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5638486-008",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KMHP",
            "identifier": "100138",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUSHC PPO",
            "identifier": "85753",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012483040007",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "01248304-05",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHPE",
            "identifier": "0457700000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "627939",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "34238OS006490L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.