Individual provider Active NPI

Jonathan Pan, MD

  • Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1578725123
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MT191046 Issued in PA
Practice address
3400 Spruce St
1 Maloney
Philadelphia, PA 19104-4206
Phone
(215) 662-3793
NPI assigned
Jun 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MT191046 PA Primary

Addresses

Primary practice location

3400 Spruce St
1 Maloney
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce St
1 Maloney
Philadelphia, PA 19104-4206
Phone (215) 662-3793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120824000219 CA Practitioner - Anesthesiology 9931356037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1001 Potrero Ave
San Francisco, CA 94110-3518
Phone (628) 206-8934

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.28 of 100Reported as group
Quality
89.92
Promoting interoperability
100
Improvement activities
40
Cost
78.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT191046PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group Anesthesiology CurrentSince Jul 7, 2012 Accepting new patients
University of California SFGH Medical Group CurrentSince Jul 7, 2012 Accepting new patients
UCSF Medical Center Anesthesiology Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

1001 Potrero Ave
Rm 3C34
San Francisco, CA 94110
Phone (628) 206-8934

1001 Potrero Ave
Rm 3C38
San Francisco, CA 94110
Phone (415) 206-8145

1001 Potrero Ave
Bldg 5
San Francisco, CA 94110
Phone (628) 206-5753

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1578725123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "1 MALONEY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "1 MALONEY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "JONATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MT191046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.