Individual provider Active NPI

Noah B Daniels, M.D.

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1679953145
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD463557 Issued in PA
Practice address
160 E Erie Ave
Philadelphia, PA 19134-1011
Phone
(215) 427-5000
NPI assigned
May 31, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD463557 PA Primary

Addresses

Primary practice location

160 E Erie Ave
Philadelphia, PA 19134-1011

Mailing address

4701 Sangamore Rd Ste N100
Bethesda, MD 20816-2558
Phone (914) 919-9200

Other practice location 1

4701 Sangamore Rd Ste N100
Bethesda, MD 20816-2558
Phone (914) 919-9200

Other practice location 2

4625 Lindell Blvd Fl 2
Saint Louis, MO 63108-3739
Phone (914) 919-9200

Other names 1

  • Noah Buboltz Former name

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
I20200226000081 PA Practitioner - Pediatric Medicine 4183051436 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
STC Pediatrics LLC Pediatrics CurrentSince Dec 1, 2019 Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Dec 1, 2019 Accepting new patients
STC Pediatrics LLC Pediatrics Current Accepting new patients
STC Pediatrics LLC Pediatrics Past Accepting new patients

Locations

153 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 526-3200

9501 Roosevelt Blvd
Ste 305
Philadelphia, PA 19114
Phone (215) 671-4280

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

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.

NPI Registry JSON

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

{
    "created_epoch": "1433030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1679953145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 SANGAMORE RD STE N100",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208162558",
            "telephone_number": "914-919-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4701 Sangamore Rd Ste N100",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208162558",
            "country_code": "US",
            "telephone_number": "914-919-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4625 Lindell Blvd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631083739",
            "country_code": "US",
            "telephone_number": "914-919-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "NOAH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-31",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD463557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOAH",
            "last_name": "BUBOLTZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.