Individual provider Active NPI

Leonard M. Popowich, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1497824775
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS001025L Issued in PA
Practice address
2403 E York St
Philadelphia, PA 19125-3005
Phone
(215) 427-2552
Fax
(215) 426-3851
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS001025L PA Primary

Addresses

Primary practice location

2403 E York St
Philadelphia, PA 19125-3005

Mailing address

2403 E York St
Philadelphia, PA 19125-3005
Phone (215) 427-2552

Other identifiers 1

IdentifierTypeStateIssuer
067587301MedicaidPA

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
I20080924000104 PA Practitioner - Family Practice 2860569464 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS001025LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Leonard M Popowich P.C Family Medicine CurrentSince Jul 24, 2008 Accepting new patients

Locations

2403 E York St
Philadelphia, PA 19125
Phone (215) 427-2552

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1497824775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 E YORK ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253005",
            "telephone_number": "215-427-2552",
            "fax_number": "215-426-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 E YORK ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253005",
            "telephone_number": "215-427-2552",
            "fax_number": "215-426-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPOWICH",
        "first_name": "LEONARD",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS001025L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067587301",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.