Individual provider Active NPI

Christopher W. Komurek, D.O.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1427343490
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS016439 Issued in PA
Practice address
10800 Knights Rd
Philadelphia, PA 19114-4200
Phone
(215) 612-4963
Fax
(215) 612-4532
NPI assigned
Jun 17, 2011
Last updated
Jul 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS016439 PA Primary

Addresses

Primary practice location

10800 Knights Rd
Philadelphia, PA 19114-4200

Mailing address

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-4963

Other practice location 1

2966 Street Rd
Bensalem, PA 19020-2604
Phone (215) 638-0666

Other practice location 2

2451 Grant Ave
Philadelphia, PA 19114-1031
Phone (215) 934-3471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150715001425 PA Practitioner - Emergency Medicine 2062421407 Reassigns benefits to 2 organizations
I20200319002846 FL Practitioner - Emergency Medicine 2062421407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians

Practice addresses (Care Compare)

11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone (352) 596-6632

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS016439PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Jun 9, 2019 Accepting new patients
Emergency Physician Associates of Pennsylvania, PC Emergency Medicine CurrentSince Jun 1, 2018 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Jun 9, 2019 Accepting new patients
Jefferson Acute Care Physicians, PC Current Accepting new patients

Locations

11375 Cortez Blvd
Fl Oak
Brooksville, FL 34613
Phone (352) 592-2753

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

2966 Street Rd
Bensalem, PA 19020
Phone (215) 638-0666

2451 Grant Ave
Philadelphia, PA 19114
Phone (215) 464-8050

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1427343490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-4963",
            "fax_number": "215-612-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-4963",
            "fax_number": "215-612-4532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2966 Street Rd",
            "address_purpose": "LOCATION",
            "city": "Bensalem",
            "state": "PA",
            "postal_code": "190202604",
            "country_code": "US",
            "telephone_number": "215-638-0666",
            "fax_number": "215-638-3320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2451 Grant Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191141031",
            "country_code": "US",
            "telephone_number": "215-934-3471",
            "fax_number": "215-934-3472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOMUREK",
        "first_name": "CHRISTOPHER",
        "middle_name": "W.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS016439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.