Individual provider Active NPI

Kenneth J. Neuburger, M.D.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1518982974
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD-025774-E Issued in PA
Practice address
1020 Sansom Street
Suite 239
Philadelphia, PA 19107-5004
Phone
(215) 955-6844
Fax
(215) 955-2526
NPI assigned
Jul 13, 2006
Last updated
Mar 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD-025774-E PA Primary

Addresses

Primary practice location

1020 Sansom Street
Suite 239
Philadelphia, PA 19107-5004

Mailing address

1020 Sansom St
Suite 239
Philadelphia, PA 19107-5002
Phone (215) 955-6844

Other identifiers 2

IdentifierTypeStateIssuer
556602MedicaidNJ
000907637MedicaidPA

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
I20041201000610 PA Practitioner - Internal MedicinePractitioner - Emergency Medicine 6204891260 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Albany Medical College of Union University, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

1020 Sansom St
Suite 239
Philadelphia, PA 19107-5002
Phone (215) 955-6844

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-025774-EPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Acute Care Physicians, PC CurrentSince Dec 20, 2020 Accepting new patients
Jefferson University Physicians Emergency Medicine CurrentSince Jul 13, 1983 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Dec 20, 2020 Accepting new patients

Locations

1020 Sansom St
Ste 239
Philadelphia, PA 19107
Phone (215) 955-6844

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

700 Walnut St
Philadelphia, PA 19106
Phone (215) 503-7300

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1518982974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST",
            "address_2": "SUITE 239",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075002",
            "telephone_number": "215-955-6844",
            "fax_number": "215-955-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SANSOM STREET",
            "address_2": "SUITE 239",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075004",
            "telephone_number": "215-955-6844",
            "fax_number": "215-955-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUBURGER",
        "first_name": "KENNETH",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD-025774-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "556602",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000907637",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.