Active NPI
Kassie Jean Bollig, MD
- Obstetrics & Gynecology Physician
- Philadelphia, PA
National Provider Identifier
1477901460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 2016017329
- Practice address
- 3701 Market St
Philadelphia, PA 19104-5502 - Phone
- (215) 301-6861
- NPI assigned
- May 31, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Reproductive Endocrinology Physician | 207VE0102X | MT221504 | PA | |
| Obstetrics & Gynecology Physician | 207V00000X | 2016017329 | MO | Primary |
Addresses
Primary practice location
3701 Market St
Philadelphia, PA 19104-5502
Mailing address
3701 Market St
Philadelphia, PA 19104-5502
Phone (215) 301-6861
Other names 1
- Dr. Kassie Jean Hyde
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rma of NJ | Reproductive Endocrinology | Past | Accepting new patients |
Interoperability endpoints
- kbollig510313@direct.ahsys.org
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.
-
- Reproductive Endocrinology Physician
- Basking Ridge, NJ
- NPI 1992712558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593734400000",
"number": "1477901460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3701 MARKET ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191045502",
"telephone_number": "215-301-6861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 MARKET ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191045502",
"telephone_number": "215-301-6861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLLIG",
"first_name": "KASSIE",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-31",
"last_updated": "2020-07-03",
"certification_date": "2020-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "PA",
"license": "MT221504",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MO",
"license": "2016017329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KASSIE",
"last_name": "HYDE",
"middle_name": "JEAN",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}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 Jul 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.