Individual provider Active NPI

David Alan Zwillenberg, MD

  • Otolaryngology Physician
  • Philadelphia, PA
National Provider Identifier
1356525216
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD021329E Issued in PA
Practice address
3601 A Street
Suite 2205
Philadelphia, PA 19134-1095
Phone
(215) 427-8915
Fax
(215) 427-4603
NPI assigned
Dec 27, 2007
Last updated
Dec 27, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD021329E PA Primary

Addresses

Primary practice location

3601 A Street
Suite 2205
Philadelphia, PA 19134-1095

Mailing address

3601 A Street
Suite 2205
Philadelphia, PA 19134-1095
Phone (215) 427-8915

Other identifiers 2

IdentifierTypeStateIssuer
046804OtherPAMEDICARE
0007832530004MedicaidPA

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
I20110310000251 PA Practitioner - Otolaryngology 5698957744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Toledo College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
STC Pediatrics LLCGroup PAC ID 7315372323, 73 clinicians

Practice addresses (Care Compare)

160 E Erie Ave
Philadelphia, PA 19134-1011

300 E Hunting Park Ave
St Christophers Ped Assoc Child Protection
Philadelphia, PA 19124-6018
Phone (215) 427-8363

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
STC Pediatrics LLC CurrentSince Dec 1, 2019 Accepting new patients
STC Pediatrics LLC CurrentSince Dec 1, 2019 Accepting new patients
STC Pediatrics LLC Current Accepting new patients
STC Pediatrics LLC Past Accepting new patients

Locations

153 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 526-3200

500 York Rd
Ste 250
Jenkintown, PA 19046
Phone (215) 572-5300

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

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, 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": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1356525216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 A STREET",
            "address_2": "SUITE 2205",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341095",
            "telephone_number": "215-427-8915",
            "fax_number": "215-427-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 A STREET",
            "address_2": "SUITE 2205",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341095",
            "telephone_number": "215-427-8915",
            "fax_number": "215-427-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWILLENBERG",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD021329E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "046804",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007832530004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.