Active NPI
Stephan Harris Whitenack, MD
- Vascular Surgery Physician
- Philadelphia, PA
National Provider Identifier
1538127907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- MD016782E
- Practice address
- 5401 Old York Rd
Klein 101
Philadelphia, PA 19141-3030 - Phone
- (215) 456-6178
- Fax
- (215) 456-6204
- NPI assigned
- May 3, 2006
- Last updated
- Jan 16, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD016782E | PA | |
| Vascular Surgery Physician | 2086S0129X | MD016782E | PA | Primary |
Addresses
Primary practice location
5401 Old York Rd
Klein 101
Philadelphia, PA 19141-3030
Mailing address
PO Box 8500-8735
Philadelphia, PA 19178-8735
Phone (215) 456-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0006557540001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chestnut Hill Clinic Company, LLC | Surgery | Past | Accepting new patients |
Interoperability endpoints
- stephan.whitenack@direct.einstein.edu
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Behavioral Health Chestnut Hill Ave Tower Health Medical Group
- Internal Medicine Physician
- Philadelphia, PA
- NPI 1508936071
Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358294400000",
"number": "1538127907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8500-8735",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191788735",
"telephone_number": "215-456-7000",
"fax_number": "215-254-2599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5401 OLD YORK RD",
"address_2": "KLEIN 101",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191413030",
"telephone_number": "215-456-6178",
"fax_number": "215-456-6204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITENACK",
"first_name": "STEPHAN",
"middle_name": "HARRIS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2013-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MD016782E",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "PA",
"license": "MD016782E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0006557540001",
"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 Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.