NPIMap

Organization Active NPI

Temple Faculty Practice Plan, Inc

Doing business as Temple Faculty Vascular Surgery Associates

  • Vascular Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1396228508
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
TEMPLE FACULTY PRACTICE PLAN, INC
Doing business as
Temple Faculty Vascular Surgery Associates
Practice address
3509 N Broad St
Philadelphia, PA 19140-4105
Phone
(215) 707-8484
Fax
(215) 707-3945
NPI assigned
Sep 13, 2018
Last updated
Sep 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Authorized official

Name
Tonya Woodard
Title
Director Revenue Cycle
Phone
(215) 707-3911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X NU Primary

Addresses

Primary practice location

3509 N Broad St
Philadelphia, PA 19140-4105

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-8484

Other practice location 1

1650 Huntingdon Pike
Meadowbrook, PA 19046-8004
Phone (215) 938-1660

Other practice location 2

7500 Central Ave
Philadelphia, PA 19111-2430
Phone (215) 707-3133

Other names 1

  • Temple Faculty Vascular Surgery Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190208002623 PA Part B Supplier - Clinic/Group Practice 0345588711 Receives reassigned benefits from 2,095 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Temple Fac Prac Plan Inc31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536796800000",
    "number": "1396228508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-8484",
            "fax_number": "215-707-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105",
            "telephone_number": "215-707-8484",
            "fax_number": "215-707-3945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Huntingdon Pike",
            "address_purpose": "LOCATION",
            "city": "Meadowbrook",
            "state": "PA",
            "postal_code": "190468004",
            "country_code": "US",
            "telephone_number": "215-938-1660",
            "fax_number": "215-938-2186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7500 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191112430",
            "country_code": "US",
            "telephone_number": "215-707-3133",
            "fax_number": "215-707-3945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEMPLE FACULTY PRACTICE PLAN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE",
        "authorized_official_telephone_number": "215-707-3911"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temple Faculty Vascular 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 Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.