Individual provider Active NPI

Jeffrey J. Maron, DO

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1295775963
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS003134L Issued in PA
Practice address
144 Snyder Ave
Philadelphia, PA 19148-2641
Phone
(215) 336-5566
Fax
(215) 336-5568
NPI assigned
Jun 8, 2006
Last updated
Jun 29, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS003134L PA Primary

Addresses

Primary practice location

144 Snyder Ave
Philadelphia, PA 19148-2641

Mailing address

2 Dundee Mews
Media, PA 19063-1167
Phone (610) 325-5701

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
I20060301000575 PA Practitioner - Internal Medicine 0446266308 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS003134LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Residentialist Housecall Med GRP, PC a Pennsylvania Corp CurrentSince May 9, 2017 Accepting new patients
Housecall Doctors Medical Group Inc PastSince May 9, 2017 Accepting new patients

Locations

3800 Kilroy Airport Way
Ste 270
Long Beach, CA 90806
Phone (949) 366-1053

4190 City Ave
Ste 528
Philadelphia, PA 19131
Phone (866) 453-8800

Organizations & group practices 2

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1295775963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DUNDEE MEWS",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631167",
            "telephone_number": "610-325-5701",
            "fax_number": "610-325-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 SNYDER AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482641",
            "telephone_number": "215-336-5566",
            "fax_number": "215-336-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARON",
        "first_name": "JEFFREY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS003134L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.