NPIMap

Individual provider Active NPI

John Peniston, DO

  • Family Medicine Physician
  • Feasterville, PA
National Provider Identifier
1265438642
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS006904L Issued in PA
Practice address
1665 Bustleton Pike
Feasterville, PA 19053-7305
Phone
(215) 355-9770
NPI assigned
Jun 22, 2005
Last updated
Nov 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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 OS006904L PA Primary

Addresses

Primary practice location

1665 Bustleton Pike
Feasterville, PA 19053-7305

Mailing address

1665 Bustleton Pike
Feasterville, PA 19053-7305
Phone (215) 355-9770

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
I20040119000545 PA Practitioner - Family Practice 2365343605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 E Olney Ave
Philadelphia, PA 19120-2470
Phone (215) 927-1937

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Acute Care Physicians, PC CurrentSince Sep 9, 2019 Accepting new patients
Einstein Community Health Associates, Inc CurrentSince Dec 15, 2024 Accepting new patients
Einstein Community Health Associates, Inc Family Medicine CurrentSince Dec 15, 2024 Accepting new patients
Jefferson Acute Care Physicians, PC Current Accepting new patients
Abington Memorial Hospital Past Accepting new patients

Locations

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

1665 Bustleton Pike
Fstrvl Trvose, PA 19053
Phone (215) 355-8437

101 E Olney Ave
Ste C5
Philadelphia, PA 19120
Phone (215) 927-1937

700 Walnut St
Philadelphia, PA 19106
Phone (215) 503-7300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1265438642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 BUSTLETON PIKE",
            "city": "FEASTERVILLE",
            "state": "PA",
            "postal_code": "190537305",
            "telephone_number": "215-355-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 BUSTLETON PIKE",
            "city": "FEASTERVILLE",
            "state": "PA",
            "postal_code": "190537305",
            "telephone_number": "215-355-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENISTON",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006904L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Feasterville, PA

Sources for this page

Verify at the official NPI Registry.