Temple University of the Commonwealth System of Higher Education

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION

Doing business as

Temple Orthopedics and Sports Medicine

Practice address

7604 Central Ave
Philadelphia, PA 19111-2433

Phone

(215) 214-6655

Fax

(215) 214-6654

NPI assigned

Oct 6, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Thomas G Kupp

Title

Cfo

Phone

(215) 707-7551

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Temple Orthopedics and Sports Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226275200000",
    "number": "1306833132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 N CARLISLE ST",
            "address_2": "2ND FLOOR, HUDSON BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405108",
            "telephone_number": "215-707-4739",
            "fax_number": "215-707-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7604 CENTRAL AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112433",
            "telephone_number": "215-214-6655",
            "fax_number": "215-214-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2008-11-10",
        "status": "A",
        "authorized_official_last_name": "KUPP",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "215-707-7551",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130110",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temple Orthopedics and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education

• Sports Medicine (Orthopaedic Surgery) Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; 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.