NPIMap

Organization Active NPI

Temple University of the Commonwealth System of Higher Education

  • Pediatric Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1376531293
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
Legal business name
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Doing business as
Temple General Surgery Associates
Practice address
3509 N Broad St
5TH FL Tucmc
Philadelphia, PA 19140-4105
Phone
(215) 707-6430
Fax
(215) 707-1915
NPI assigned
Oct 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Thomas G Kupp
Title
Cfo
Phone
(215) 707-7551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0120X Primary

Addresses

Primary practice location

3509 N Broad St
5TH FL Tucmc
Philadelphia, PA 19140-4105

Mailing address

3425 N Carlisle St
2ND FL Hudson Building
Philadelphia, PA 19140-5108
Phone (215) 707-4739

Other identifiers 1

IdentifierTypeStateIssuer
1007780130093MedicaidPA

Other names 1

  • Temple General Surgery Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Temple Diag Imaging Ass28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

2450 W Hunting Park Ave
#21
Philadelphia, PA 19129

3509 N Broad St
Fl 4
Philadelphia, PA 19140
Phone (215) 707-6144

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376531293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 N CARLISLE ST",
            "address_2": "2ND FL HUDSON BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405108",
            "telephone_number": "215-707-4739",
            "fax_number": "215-707-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "address_2": "5TH FL TUCMC",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105",
            "telephone_number": "215-707-6430",
            "fax_number": "215-707-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUPP",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "215-707-7551",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130093",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temple General Surgery Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.