NPIMap

Organization Active NPI

Temple Faculty Practice Plan Inc

Doing business as Temple Faculty Dermatology Associates

  • Dermatology Physician
  • Philadelphia, PA
National Provider Identifier
1285116228
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
TEMPLE FACULTY PRACTICE PLAN INC
Doing business as
Temple Faculty Dermatology Associates
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-3376
Fax
(215) 707-9510
NPI assigned
Sep 6, 2018
Last updated
Sep 6, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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

Authorized official

Name
Tonya Woodard
Title
Director Revenue Cycle
Phone
(215) 707-3911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-3376

Other practice location 1

1316 W Ontario St
Philadelphia, PA 19140-5220
Phone (215) 707-3376

Other practice location 2

515 Pennsylvania Ave
Fort Washington, PA 19034-3314
Phone (215) 707-3376

Other practice location 3

255 S 17th St
Philadelphia, PA 19103-6231
Phone (215) 875-2200

Other names 1

  • Temple Faculty Dermatology Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190208002623 PA Part B Supplier - Clinic/Group Practice 0345588711 Receives reassigned benefits from 2,095 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 594

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 594

NPI Registry JSON

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536192000000",
    "number": "1285116228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-3376",
            "fax_number": "215-707-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3376",
            "fax_number": "215-707-9510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1316 W Ontario St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405220",
            "country_code": "US",
            "telephone_number": "215-707-3376",
            "fax_number": "215-707-9510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Washington",
            "state": "PA",
            "postal_code": "190343314",
            "country_code": "US",
            "telephone_number": "215-707-3376",
            "fax_number": "215-707-9510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "255 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191036231",
            "country_code": "US",
            "telephone_number": "215-875-2200",
            "fax_number": "215-875-9714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEMPLE FACULTY PRACTICE PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-06",
        "last_updated": "2018-09-06",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE",
        "authorized_official_telephone_number": "215-707-3911"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temple Faculty Dermatology Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Temple Faculty Dermatology Associates",
            "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 Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.