NPIMap

Individual provider Active NPI

Jack Levin, M.D.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1376561381
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD026169L Issued in PA
Practice address
3998 Red Lion Rd
Philadelphia, PA 19114-1436
Phone
(215) 612-4000
Fax
(215) 612-4532
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD026169L PA Primary

Addresses

Primary practice location

3998 Red Lion Rd
Philadelphia, PA 19114-1436

Mailing address

PO Box 8500-6335
Philadelphia, PA 19178-0001
Phone (215) 807-8000

Other identifiers 15

IdentifierTypeStateIssuer
0009132400008MedicaidPA
20029908OtherPAAMERIHEALTH MERCY
080059643OtherPARAILROAD MEDICARE
00913240-02OtherPAAMERICHOICE - FRANKFORD
0009132400013MedicaidPA
07645OtherPAHEALTH PARTNERS
0009132400007MedicaidPA
0144152OtherPACIGNA
00913240-04OtherPAAMERICHOICE - TORRES
1090642OtherPAKEYSTONE MERCY
PA0050405OtherPATRICARE
0058566000OtherPAKEYSTONE IBC
00913240-03OtherPAAMERICHOICE - BUCKS
429318OtherPAHIGHMARK BLUE SHIELD
452729OtherPAAETNA CONTRACT

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD026169LPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physicians Services - Emergency Medicine Emergency Medicine Past Accepting new patients
Aria Health Physician Services Physical Medicine & Rehab Past Accepting new patients
Aria Health Physician Services - Pathology Past Accepting new patients
Aria Health Physician Services Emergency Medicine Past Accepting new patients
Aria Health Physician Services Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1376561381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500-6335",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780001",
            "telephone_number": "215-807-8000",
            "fax_number": "215-807-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 RED LION RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141436",
            "telephone_number": "215-612-4000",
            "fax_number": "215-612-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "JACK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD026169L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009132400008",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20029908",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080059643",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE - FRANKFORD",
            "identifier": "00913240-02",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009132400013",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "07645",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009132400007",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0144152",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE - TORRES",
            "identifier": "00913240-04",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1090642",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "PA0050405",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE IBC",
            "identifier": "0058566000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE - BUCKS",
            "identifier": "00913240-03",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "429318",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CONTRACT",
            "identifier": "452729",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 23, 2010; 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.