NPIMap

Individual provider Active NPI

John M Schoffstall, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1285663773
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD033979E Issued in PA
Practice address
501 S 54TH St
Academic ER SVCS - ER Dept
Philadelphia, PA 19143-1900
Phone
(215) 748-9435
NPI assigned
Jun 30, 2006
Last updated
Apr 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD033979E PA Primary

Addresses

Primary practice location

501 S 54TH St
Academic ER SVCS - ER Dept
Philadelphia, PA 19143-1900

Mailing address

12 Gill St
Ste 3000
Woburn, MA 01801-1728
Phone (781) 937-4522

Other identifiers 6

IdentifierTypeStateIssuer
0010112320MedicaidPA
0010112320012OtherPAPROMISE
184395OtherPABS
184395OtherPAHIGHMARK BS
1005271OtherPAKEYSTONE MERCY
0062055000OtherPAKEYSTONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD033979EPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Catholic Medical Center of Southeastern,PA Past Accepting new patients
Ephrata Community Hospital Past Accepting new patients
Mercy Catholic Medical Center of Southeastern PA Past Accepting new patients

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1285663773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 GILL ST",
            "address_2": "STE 3000",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011728",
            "telephone_number": "781-937-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 54TH ST",
            "address_2": "ACADEMIC ER SVCS - ER DEPT",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431900",
            "telephone_number": "215-748-9435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOFFSTALL",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD033979E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010112320",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROMISE",
            "identifier": "0010112320012",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "184395",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS",
            "identifier": "184395",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1005271",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0062055000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.