Nazareth Physician Services, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NAZARETH PHYSICIAN SERVICES, INC.

Practice address

1403 Rhawn St
Philadelphia, PA 19111-2803

Phone

(215) 335-8100

NPI assigned

Mar 5, 2020

Organization subpart

No

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

Authorized official

Name

Julie Keese

Title

VP, Finance and Cfo

Phone

(301) 754-7201

Specialties & licenses 1

Addresses

Other names 1

• Nazareth Health Endoscopy Center Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Listed as

Nazareth Physician Services Dba Nazareth Health Endoscopy CenterCCN 39C0001223

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Bone, FNP-BC

  • Family Nurse Practitioner
  • Philadelphia, PA
  • NPI 1205609518
  Medicare reassignment
• Keith Joseph Buhl, M.D.

  • Gastroenterology Physician
  • Philadelphia, PA
  • NPI 1962428433
  Medicare reassignment
• Mark Stephen Codella, M.D.

  • Gastroenterology Physician
  • Philadelphia, PA
  • NPI 1356361919
  Medicare reassignment
• Maimon Hubbi, MD

  • Gastroenterology Physician
  • Philadelphia, PA
  • NPI 1942549738
  Medicare reassignment
• Alan M Mermelstein, MD

  • Gastroenterology Physician
  • Phila, PA
  • NPI 1073520458
  Medicare reassignment
• Mohan R Rengen, DO

  • Gastroenterology Physician
  • Camp Hill, PA
  • NPI 1801846043
  Medicare reassignment
• David M. Zisa, M.D.

  • Gastroenterology Physician
  • Philadelphia, PA
  • NPI 1962404848
  Medicare reassignment
• Sigrid A Larson, MD

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1861485245
  NPD (past)

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773360000000",
    "number": "1275168718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 UNIVERSITY DR STE 300",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401873",
            "telephone_number": "734-343-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 RHAWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112803",
            "telephone_number": "215-335-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAZARETH PHYSICIAN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-05",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A",
        "authorized_official_last_name": "KEESE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "VP, FINANCE AND CFO",
        "authorized_official_telephone_number": "301-754-7201"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd Ste 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Nazareth Health Endoscopy Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nazareth Physician Services, Inc
• Nazareth Physician Services, Inc
• Nazareth Physician Services, Inc.
• Nazareth Physician Services, Inc.
• Nazareth Physician Services, Inc.
• Nazareth Physician Services, Inc.
• Nazareth Physician Services, Inc.
• Nazareth Physician Services, Inc.
• Nazareth Physician Services, Inc.
• Nazareth Physician Services, Inc.

• Ambulatory Surgical Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.