Individual provider Active NPI

Kathleen Maguire

  • Orthopaedic Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1609133859
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD467645 Issued in PA
Practice address
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone
(215) 590-1527
NPI assigned
Apr 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MA10656400 NJ
Orthopaedic Surgery Physician 207X00000X MD467645 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Mailing address

100 E Penn SQ FL 9
Philadelphia, PA 19107-3377
Phone (267) 425-9538

Other practice location 1

200 Bowman Dr Fl 2
Voorhees, NJ 08043-9623
Phone (215) 590-1527

Other practice location 2

1935 Eastchester Rd
Apt 11G
Bronx, NY 10461-2140
Phone (781) 820-4960

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
I20200415002039 PA Practitioner - Orthopedic Surgery 6901236942 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA10656400NJMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Surgical Associates LTD CurrentSince Oct 3, 2022 Accepting new patients
Children'S Surgical Associates LTD Current Accepting new patients
Children'S Surgical Associates LTD Past Accepting new patients
Children'S Surgical Associates LTD Orthopaedic Surgery Past Accepting new patients
Children'S Surgical Associates of New Jersey Inc Orthopaedic Surgery Past Accepting new patients

Locations

3401 Civic Center Blvd
Ste 34
Philadelphia, PA 19104

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169

Organizations & group practices 5

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": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1609133859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ FL 9",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073377",
            "telephone_number": "267-425-9538",
            "fax_number": "267-425-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Bowman Dr Fl 2",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439623",
            "country_code": "US",
            "telephone_number": "215-590-1527",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1935 Eastchester Rd",
            "address_2": "Apt 11G",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104612140",
            "country_code": "US",
            "telephone_number": "781-820-4960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGUIRE",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "MA10656400",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD467645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.