Individual provider Active NPI

Jeffrey R Greenspan, D.O.

  • Gastroenterology Physician
  • Philadelphia, PA
National Provider Identifier
1356376479
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
OS005516L Issued in PA
Practice address
9501 Roosevelt Blvd
Suite 103
Philadelphia, PA 19114-1025
Phone
(215) 671-9900
Fax
(215) 671-9110
NPI assigned
Jul 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X OS005516L PA Primary

Addresses

Primary practice location

9501 Roosevelt Blvd
Suite 103
Philadelphia, PA 19114-1025

Mailing address

9501 Roosevelt Blvd
Suite 103
Philadelphia, PA 19114-1025
Phone (215) 671-9900

Other identifiers 1

IdentifierTypeStateIssuer
0105249601MedicaidPA

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
I20050922000205 PA Practitioner - GastroenterologyPractitioner - Internal Medicine 7911931613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Gastroenterology Associates of Lancaster, LTD.Group PAC ID 4688575434, 248 clinicians

Practice addresses (Care Compare)

475 Enterprise Dr
202 Royersford Office
Royersford, PA 19468-1236
Phone (610) 674-4401

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy171
Upper gastrointestinal (GI) endoscopy for acid reflux72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Gastroenterology Associates of Lancaster, LTD. Gastroenterology CurrentSince Jan 1, 2023 Accepting new patients
Regional Gastroenterology Associates of Lancaster, LTD. CurrentSince Jan 1, 2023 Accepting new patients

Locations

2112 Harrisburg Pike
Ste 202
Lancaster, PA 17601
Phone (717) 544-3500

475 Enterprise Dr
Ste 202
Royersford, PA 19468
Phone (610) 674-4401

100 E Lancaster Ave
Ste 252
Wynnewood, PA 19096
Phone (610) 896-7360

Organizations & group practices 3

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356376479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 ROOSEVELT BLVD",
            "address_2": "SUITE 103",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141025",
            "telephone_number": "215-671-9900",
            "fax_number": "215-671-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 ROOSEVELT BLVD",
            "address_2": "SUITE 103",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141025",
            "telephone_number": "215-671-9900",
            "fax_number": "215-671-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENSPAN",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "OS005516L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0105249601",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.