Individual provider Active NPI

Eugene Herbert Siegel, D.O.

  • Family Medicine Physician
  • Phila, PA
National Provider Identifier
1306826656
Registry record updated Oct 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS002616L Issued in PA
Practice address
6410A Rising Sun Ave
Phila, PA 19111-5229
Phone
(215) 342-6777
Fax
(215) 722-1259
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2013

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 OS002616L PA Primary

Addresses

Primary practice location

6410A Rising Sun Ave
Phila, PA 19111-5229

Mailing address

PO Box 820933
Phila, PA 19182-0933
Phone (215) 342-6777

Other identifiers 2

IdentifierTypeStateIssuer
101744459MedicaidPA
597586OtherPAMEDICARE GROUP

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
I20100610000586 PA Practitioner - Family Practice 3173653524 Reassigns benefits to 1 organization
Practice locations: Philadelphia, PA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physicians Inc Family Medicine Current Accepting new patients
Temple Physicians Inc. CurrentSince Feb 7, 2011 Accepting new patients
Temple Physician Inc. CurrentSince Feb 7, 2011 Accepting new patients
Temple Physicians Inc Family Medicine Past Accepting new patients
Temple Physicians Inc Family Medicine Past Accepting new patients
Temple Physicians Inc. Past Accepting new patients
Temple Physicians Inc Family Medicine Past Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

6410A Rising Sun Ave
Philadelphia, PA 19111
Phone (215) 342-6777

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382313600000",
    "number": "1306826656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820933",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191820933",
            "telephone_number": "215-342-6777",
            "fax_number": "215-722-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410A RISING SUN AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191115229",
            "telephone_number": "215-342-6777",
            "fax_number": "215-722-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "EUGENE",
        "middle_name": "HERBERT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2013-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS002616L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101744459",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "597586",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

Verify at the official NPI Registry.