Individual provider Active NPI

Steven Marc Back, M.D.

  • Anesthesiology Physician
  • Bensalem, PA
National Provider Identifier
1376572875
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA09723700 Issued in NJ
Practice address
3300 Tillman Dr
Bensalem, PA 19020-2071
Phone
(215) 244-7400
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD467107 PA
Anesthesiology Physician 207L00000X A78879 CA
Anesthesiology Physician 207L00000X 25MA09723700 NJ Primary

Addresses

Primary practice location

3300 Tillman Dr
Bensalem, PA 19020-2071

Mailing address

610 W. Plymouth Meeting
Suite 150
Bryn Mawr, PA 19462
Phone (610) 525-4966

Other identifiers 1

IdentifierTypeStateIssuer
00A788790MedicaidCA

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
I20191014003303 PA Practitioner - Anesthesiology 6406959758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Northwestern University Feinberg Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Anesthesia Services PCGroup PAC ID 3173437613, 437 clinicians

Practice addresses (Care Compare)

3300 Tillman Dr
Bensalem, PA 19020-2071
Phone (215) 244-7400

744 W Lancaster Ave
Wayne, PA 19082-2523
Phone (610) 645-2000

Hospital & facility affiliations

  • Rothman Orthopaedic Specialty Hospital Hospital, Bensalem, PA, CCN 390322

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A78879CAMDAnesthesiology Physician
MD467107PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Anesthesiology Medical Group Anesthesiology PastSince Sep 23, 2024 Accepting new patients
Pacific Valley Medical Group Anesthesiology Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1376572875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W. PLYMOUTH MEETING",
            "address_2": "SUITE 150",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "19462",
            "telephone_number": "610-525-4966",
            "fax_number": "610-525-0874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 TILLMAN DR",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190202071",
            "telephone_number": "215-244-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACK",
        "first_name": "STEVEN",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD467107",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A78879",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA09723700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A788790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensalem, PA

Sources for this page

Verify at the official NPI Registry.