Robert Alan Promisloff, D.O.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

OS003149L Issued in PA

Practice address

1001 City Line Ave
WB 113
Wynnewood, PA 19096-3902

Phone

(610) 896-0280

Fax

(610) 896-0286

NPI assigned

Nov 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Drexel University

  • Psychologist
  • Philadelphia, PA
  • NPI 1902900095
  Medicare reassignment NPD
• Drexel University

  • Audiologist
  • Elkins Park, PA
  • NPI 1104822253
  NPD
• Drexel University

  • Nurse Practitioner
  • Philadelphia, PA
  • NPI 1790203669
  NPD

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1487635587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CITY LINE AVE",
            "address_2": "WB 113",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963902",
            "telephone_number": "610-896-0280",
            "fax_number": "610-896-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 CITY LINE AVE",
            "address_2": "WB 113",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963902",
            "telephone_number": "610-896-0280",
            "fax_number": "610-896-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROMISLOFF",
        "first_name": "ROBERT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "OS003149L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000707968",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Presley, CRNP
• Danielle Price, CRNP
• Jamiya Price, CRNA
• Victoria Primiano, OTD, OTR/L
• Patrick Prior
• Claire Provenzo, PA-C
• Danuta Honorata Przewor-Jones, M.D
• Pulmonology Associates Inc
• Sarah Katherine Purcell
• Marita Pyankov

• Pulmonary Disease Physician in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Pulmonary Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.

Verify at the official NPI Registry.