Nazareth Physician Services Inc

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

NAZARETH PHYSICIAN SERVICES INC

Practice address

2701 Holme Ave
Suite 205
Philadelphia, PA 19152-2029

Phone

(215) 543-1026

Fax

(215) 338-1250

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Lance Castle

Title

Sir Dir Physician Billing

Phone

(610) 567-5520

Specialties & licenses 3

Addresses

Other identifiers 4

Locations

Practitioners 2

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

• Timothy Casey McCullough, D.O.

  • Urology Physician
  • Johns Creek, GA
  • NPI 1881808947
  NPD (past)
• Pasquale D Vassalluzzo, MD

  • Adult Medicine Physician
  • Atco, NJ
  • NPI 1861498560
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1699726844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "address_2": "SUITE 100",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282007",
            "telephone_number": "610-567-6967",
            "fax_number": "610-567-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 HOLME AVE",
            "address_2": "SUITE 205",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522029",
            "telephone_number": "215-543-1026",
            "fax_number": "215-338-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAZARETH PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "CASTLE",
        "authorized_official_first_name": "LANCE",
        "authorized_official_title_or_position": "SIR DIR PHYSICIAN BILLING",
        "authorized_official_telephone_number": "610-567-5520"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC#",
            "identifier": "2457876000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014655140002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA OFFICE #",
            "identifier": "425807",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "NA1775677",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nazareth Physician Services Inc
• Nazareth Physician Services Inc
• Nazareth Physician Services Inc
• Nazareth Physician Services Inc
• Nazareth Physician Services Inc
• Nazareth Physician Services, Inc
• Nazareth Physician Services, Inc
• Nazareth Physician Services, Inc.
• Nazareth Physician Services, Inc.
• Nazareth Physician Services, Inc.

• Vascular Surgery Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Vascular Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.