Individual provider Active NPI

Peter Bosniak, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1346472396
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA053922 Issued in PA
Practice address
5501 Old York Rd
Philadelphia, PA 19141-3091
Phone
(215) 456-6679
Fax
(215) 456-8502
NPI assigned
Aug 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA053922 PA Primary

Addresses

Primary practice location

5501 Old York Rd
Philadelphia, PA 19141-3091

Mailing address

101 E Olney Ave
Suite 400
Philadelphia, PA 19120-2421
Phone (215) 456-7000

Other identifiers 1

IdentifierTypeStateIssuer
MA053922OtherPA232664784

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
I20110601000368 PA Practitioner - Physician Assistant 9436297959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

4900 Frankford Ave
Suite 2
Philadelphia, PA 19124-2618
Phone (215) 831-2000

5401 Old York Rd
Philadelphia, PA 19141-3030
Phone (215) 456-3930

5401 Old York Rd Klein BLDG
Phila, PA 19141-3030

5501 Old York Rd
Phila, PA 19141-3018

5501 Old York Rd Levy 2
Einstein Pediatrics Associates
Philadelphia, PA 19141-3018
Phone (215) 456-6786

5501 Old York Rd WCB 4TH FLR
Einstein CT Surgery Assoc
Philadelphia, PA 19141-3018
Phone (215) 456-8270

Hospital & facility affiliations

  • Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Hospital Current Accepting new patients
Lich Faculty Practice Physician Assistant Past Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

Interoperability endpoints

  • Direct secure messaging: peter.bosniak@direct.einstein.edu

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1346472396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE",
            "address_2": "SUITE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202421",
            "telephone_number": "215-456-7000",
            "fax_number": "215-254-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413091",
            "telephone_number": "215-456-6679",
            "fax_number": "215-456-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSNIAK",
        "first_name": "PETER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-10",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "232664784",
            "identifier": "MA053922",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.