Individual provider Active NPI

Phillip D Holler, MD

  • Dermatology Physician
  • Philadelphia, PA
National Provider Identifier
1376701912
Registry record updated Aug 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD445582 Issued in PA
Practice address
3400 Civic Center Blvd.
1-330S Perelman Center
Philadelphia, PA 19104
Phone
(215) 662-2737
Fax
(215) 615-3424
NPI assigned
May 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD445582 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd.
1-330S Perelman Center
Philadelphia, PA 19104

Mailing address

3400 Civic Center Blvd.
1-330S Perelman Center
Philadelphia, PA 19104
Phone (215) 662-2737

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
I20120614000727 PA Practitioner - Dermatology 0749444123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-2737

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions762
Removal of skin cancer1-10
Skin biopsy211

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Jan 1, 2018 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 1, 2018 Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. Dermatology Past Accepting new patients

Locations

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

800 Spruce St
Fl 10
Philadelphia, PA 19107
Phone 2157327600102

3400 Civic Center Blvd
Fl 1
Philadelphia, PA 19104
Phone (215) 615-5864

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Civic Center Blvd
Ste 1-330S
Philadelphia, PA 19104
Phone (215) 360-0909

3737 Market St
Fl 11
Philadelphia, PA 19104
Phone (215) 662-8900

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

1000 Floral Vale Blvd
Yardley, PA 19067
Phone (215) 752-4020

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.

Hospital & facility affiliations 2

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": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1376701912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD.",
            "address_2": "1-330S PERELMAN CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-2737",
            "fax_number": "215-615-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD.",
            "address_2": "1-330S PERELMAN CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-2737",
            "fax_number": "215-615-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLER",
        "first_name": "PHILLIP",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-30",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD445582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.