Individual provider Active NPI

Jeffrey Marcus Eugene, MD

  • Pediatric Adolescent Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1326434044
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MD465239 Issued in PA
Practice address
1233 Locust St
Philadelphia, PA 19107-5453
Phone
(215) 985-4448
NPI assigned
Apr 9, 2015
Last updated
Sep 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD465239 PA
Pediatric Adolescent Medicine Physician 2080A0000X MD465239 PA Primary

Addresses

Primary practice location

1233 Locust St
Philadelphia, PA 19107-5453

Mailing address

1233 Locust St
Philadelphia, PA 19107-5453
Phone (215) 985-4448

Other practice location 1

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-6864

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
I20220221001883 PA Practitioner - Pediatric Medicine 5395135461 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD465239PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Philadelphia Fight CurrentSince Jan 24, 2024 Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc Adolescent Medicine CurrentSince Nov 9, 2021 Accepting new patients
Childen's Health Care Associates Inc. CurrentSince Nov 9, 2021 Accepting new patients
Philadelphia Fight Current Accepting new patients

Locations

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

1233 Locust St
Philadelphia, PA 19107
Phone (215) 525-8685

1233 Locust St
Fl 3
Philadelphia, PA 19107
Phone (267) 725-0252

1233 Locust St
Ste 500
Philadelphia, PA 19107
Phone (215) 790-1788

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

Organizations & group practices 5

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": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1326434044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075453",
            "telephone_number": "215-985-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075453",
            "telephone_number": "215-985-4448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Civic Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "215-590-6864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EUGENE",
        "first_name": "JEFFREY",
        "middle_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD465239",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "PA",
            "license": "MD465239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.