Individual provider Active NPI

Stephen Connery Coyle, PA-C

  • Physician Assistant
  • Abington, PA
National Provider Identifier
1366560765
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA053083 Issued in PA
Practice address
1245 Highland Ave
Suite 401
Abington, PA 19001-3725
Phone
(215) 481-6070
Fax
(215) 481-6076
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2305 MA
Physician Assistant 363A00000X MA053083 PA Primary

Addresses

Primary practice location

1245 Highland Ave
Suite 401
Abington, PA 19001-3725

Mailing address

1245 Highland Ave
Suite 401
Abington, PA 19001-3725
Phone (215) 481-6070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2305MAMDPrimary Podiatric Medicine Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1366560765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 HIGHLAND AVE",
            "address_2": "SUITE 401",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013725",
            "telephone_number": "215-481-6070",
            "fax_number": "215-481-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 HIGHLAND AVE",
            "address_2": "SUITE 401",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013725",
            "telephone_number": "215-481-6070",
            "fax_number": "215-481-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "STEPHEN",
        "middle_name": "CONNERY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "2305",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abington, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.