Individual provider Active NPI

Sean Bao-Han Rogers, DO

  • Family Medicine Physician
  • Springfield, PA
National Provider Identifier
1396321774
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS023581 Issued in PA
Practice address
965 Baltimore Pike Ste B2
Springfield, PA 19064-3997
Phone
(484) 573-5116
NPI assigned
Mar 24, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1396321774 PA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X OS023581 PA Primary

Addresses

Primary practice location

965 Baltimore Pike Ste B2
Springfield, PA 19064-3997

Mailing address

3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Phone (484) 337-1632

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
I20240513001204 PA Practitioner - Family Practice 1456753854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

201 2ND Ave
Collegeville, PA 19426-3613
Phone (610) 489-7703

965 Baltimore Pike
B2
Springfield, PA 19064-3957
Phone (484) 479-2600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1396321774PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Family Medicine CurrentSince Jun 1, 2024 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

3001 Garrett Rd
Ste C
Drexel Hill, PA 19026
Phone (610) 626-0111

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

965 Baltimore Pike
Ste B2
Springfield, PA 19064
Phone (484) 479-2600

Organizations & group practices 1

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 4

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": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1396321774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-337-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 BALTIMORE PIKE STE B2",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643997",
            "telephone_number": "484-573-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "SEAN",
        "middle_name": "BAO-HAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "1396321774",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS023581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, PA

Sources for this page

Verify at the official NPI Registry.