Individual provider Active NPI

Michael Caleb O'Neil, M.D.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1376988600
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT212463 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104
Phone
(215) 662-6305
NPI assigned
Apr 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X MT212463 PA Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104

Mailing address

28 E Benedict Ave
Havertown, PA 19083-2402

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
I20200921002679 PA Practitioner - Emergency Medicine 8729343090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Arizona College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line Emergency Med Associates LLCGroup PAC ID 9234034729, 51 clinicians

Practice addresses (Care Compare)

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (484) 337-3583

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT212463PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Aug 27, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince Aug 27, 2020 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Main Line Emergency Med Associates LLC Emergency Medicine CurrentSince Nov 1, 2022 Accepting new patients

Locations

56 W Main St
Ste 305
Christiana, DE 19702

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

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

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 4

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": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1376988600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 E BENEDICT AVE",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEIL",
        "first_name": "MICHAEL",
        "middle_name": "CALEB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT212463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.