Individual provider Active NPI

Jay S. Greenspan, MD

  • Neonatal-Perinatal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1639234594
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
MD032008E Issued in PA
Practice address
Thomas Jefferson University Hospital
111 S. 11TH Street
Philadelphia, PA 19107-4824
Phone
(215) 955-6000
Fax
(215) 923-9519
NPI assigned
Dec 22, 2006
Last updated
Dec 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X MD032008E PA Primary

Addresses

Primary practice location

Thomas Jefferson University Hospital
111 S. 11TH Street
Philadelphia, PA 19107-4824

Mailing address

PO Box 191
Provider Enrollment Dept
Rockland, DE 19732-0191
Phone (302) 651-6212

Other identifiers 3

IdentifierTypeStateIssuer
1124586MedicaidPA
7301111MedicaidMD
2401509MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120319000480 DE Practitioner - Pediatric Medicine 5799772281 Reassigns benefits to 1 organization
I20230518003124 NJ Practitioner - Pediatric Medicine 5799772281 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD032008EPAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Healthcare Associates of New Jersey PC CurrentSince Jun 1, 2023 Accepting new patients
The Nemours Foundation CurrentSince Feb 4, 2012 Accepting new patients
Childrens Health Care Associates of New Jersey PC Current Accepting new patients
The Nemours Foundation CurrentSince Feb 4, 2012 Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Jun 1, 2023 Accepting new patients
Childrens Health Care Associates, Inc Neonatal-Perinatal Medicine Past Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

101 Carnie Blvd
Voorhees, NJ 08043
Phone (856) 325-3000

1012 Laurel Oak Rd
Voorhees, NJ 08043
Phone (856) 435-0086

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

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1639234594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THOMAS JEFFERSON UNIVERSITY HOSPITAL",
            "address_2": "111 S. 11TH STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6000",
            "fax_number": "215-923-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENSPAN",
        "first_name": "JAY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "PA",
            "license": "MD032008E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124586",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301111",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2401509",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.