Organization Active NPI

Ear Nose & Throat Professional Associates

  • Otolaryngology Physician
  • Philadelphia, PA
National Provider Identifier
1508964545
Registry record updated Nov 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EAR NOSE & THROAT PROFESSIONAL ASSOCIATES
Practice address
1601 Walnut St
Ste 1405
Philadelphia, PA 19102-2944
Phone
(215) 790-1553
Fax
(215) 735-4977
NPI assigned
Sep 21, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Max L Ronis, MD
Title
President
Phone
(215) 790-1553

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Locations

1601 Walnut St
Ste 1405
Philadelphia, PA 19102
Phone (215) 790-1553

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1601 Walnut St
Ste 1405
Philadelphia, PA 19102-2944

Mailing address

1601 Walnut St
Ste 1405
Philadelphia, PA 19102-2944
Phone (215) 790-1553

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
0053359000OtherPAIBC
116585100OtherPADEPARTMENT OF LABOR

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 7, 2008.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226016000000",
    "number": "1508964545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST",
            "address_2": "STE 1405",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022944",
            "telephone_number": "215-790-1553",
            "fax_number": "215-735-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST",
            "address_2": "STE 1405",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022944",
            "telephone_number": "215-790-1553",
            "fax_number": "215-735-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR NOSE & THROAT PROFESSIONAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-11-07",
        "status": "A",
        "authorized_official_last_name": "RONIS",
        "authorized_official_first_name": "MAX",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-790-1553",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "0053359000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "116585100",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.