Individual provider Active NPI

Joseph Patrick Ondercin, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1336269828
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA001325L Issued in PA
Practice address
4510 Frankford Ave
Philadelphia, PA 19124-3602
Phone
(215) 744-1302
Fax
(215) 744-2544
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA001325L PA Primary

Addresses

Primary practice location

4510 Frankford Ave
Philadelphia, PA 19124-3602

Mailing address

432 N 6TH St
Philadelphia, PA 19123-4004
Phone (215) 925-2400

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070608000153 PA Practitioner - Physician Assistant 5698873081 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA001325LPAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Oct 3, 2016 Accepting new patients
City of Philadelphia CurrentSince Oct 3, 2016 Accepting new patients
Philadelphia Fight Past Accepting new patients

Locations

1101 Market St
Fl 10
Philadelphia, PA 19107

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

Organizations & group practices 4

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1336269828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 N 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191234004",
            "telephone_number": "215-925-2400",
            "fax_number": "215-925-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191243602",
            "telephone_number": "215-744-1302",
            "fax_number": "215-744-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONDERCIN",
        "first_name": "JOSEPH",
        "middle_name": "PATRICK",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA001325L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.