NPIMap

Organization Active NPI

Oasis Interventional Spine Care, LLC

  • Physical Medicine & Rehabilitation Physician
  • Blue Bell, PA
National Provider Identifier
1447634050
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD441402 Issued in PA
Legal business name
OASIS INTERVENTIONAL SPINE CARE, LLC
Practice address
725 Skippack Pike
Suite #130
Blue Bell, PA 19422-1741
Phone
(267) 462-4505
Fax
(267) 462-4504
NPI assigned
Jul 13, 2015
Last updated
Aug 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Authorized official

Name
Mathew J. Abraham, MDNPI 1083818512
Title
Director/Owner
Phone
(267) 462-4505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X MD441402 PA Primary

Addresses

Primary practice location

725 Skippack Pike
Suite #130
Blue Bell, PA 19422-1741

Mailing address

725 Skippack Pike
Suite #130
Blue Bell, PA 19422-1741
Phone (267) 462-4505

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150824001949 PA Part B Supplier - Clinic/Group Practice 7618283417 Receives reassigned benefits from 2 practitioners
Practice locations: Blue Bell, PA

National Provider Directory

National Provider Directory

Locations

725 Skippack Pike
Ste 130
Blue Bell, PA 19422
Phone (215) 591-0700

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440374400000",
    "number": "1447634050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 SKIPPACK PIKE",
            "address_2": "SUITE #130",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221741",
            "telephone_number": "267-462-4505",
            "fax_number": "267-462-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 SKIPPACK PIKE",
            "address_2": "SUITE #130",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221741",
            "telephone_number": "267-462-4505",
            "fax_number": "267-462-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OASIS INTERVENTIONAL SPINE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-08-24",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "267-462-4505",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD441402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Bell, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.