NPIMap

Organization Active NPI

Dr. John Trzesniowski LLC

  • General Practice Physician
  • Philadelphia, PA
National Provider Identifier
1649692500
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS003175L Issued in PA
Legal business name
DR. JOHN TRZESNIOWSKI LLC
Practice address
2716 E Allegheny Ave
Philadelphia, PA 19134-5916
Phone
(215) 426-3610
Fax
(215) 426-6835
NPI assigned
Jan 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Authorized official

Name
Dr. John G Trzesniowski, D.O.NPI 1144264664
Title
Physician
Phone
(215) 426-3610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X OS003175L PA Primary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X OS016628 PA

Addresses

Primary practice location

2716 E Allegheny Ave
Philadelphia, PA 19134-5916

Mailing address

2716 E Allegheny Ave
Philadelphia, PA 19134-5916
Phone (215) 426-3610

Other identifiers 1

IdentifierTypeStateIssuer
0006115620001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140813000272 PA Part B Supplier - Clinic/Group Practice 4880811918 Receives reassigned benefits from 5 practitioners
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

2925 E Thompson St
Ste 101
Philadelphia, PA 19134

2716 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 426-3610

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389830400000",
    "number": "1649692500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191345916",
            "telephone_number": "215-426-3610",
            "fax_number": "215-426-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191345916",
            "telephone_number": "215-426-3610",
            "fax_number": "215-426-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JOHN TRZESNIOWSKI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-13",
        "last_updated": "2014-01-16",
        "status": "A",
        "authorized_official_last_name": "TRZESNIOWSKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "215-426-3610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "PA",
            "license": "OS003175L",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "PA",
            "license": "OS016628",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006115620001",
            "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, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.