Suburban Medical Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SUBURBAN MEDICAL GROUP LLC

Practice address

2701 Dekalb Pike
East Norriton, PA 19401-1820

Phone

(610) 278-2002

Fax

(610) 272-4642

NPI assigned

Sep 3, 2015

Last updated

Oct 25, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Doan

Title

Managing Associate General Counsel

Phone

(310) 259-4706

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, GA, NJ, NY, OR, FL, VA, CA, MD9 enrollments

Enrollment records 9

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Prime Healthcare Services Roxborough LLC

  dba Roxborough Memorial Hospital

  • Psychiatric Hospital Unit
  • Philadelphia, PA
  • NPI 1093087157

  Member Of

  NPD member
• Health Emergency Assistance of Detroit

  dba Corktown Health

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1285092767

  Member Of

  NPD member

Locations

Practitioners 131

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anil T Abraham, MD

  • Anesthesiology Physician
  • East Norriton, PA
  • NPI 1730225442

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Omar Kamaleddin Ben Amer, M.D.

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1942639877
  Medicare reassignment Care Compare group NPD
• Dominic J Bontempo, D.O.

  • Surgery Physician
  • Norristown, PA
  • NPI 1992795413
  Medicare reassignment Care Compare group NPD
• Roderick Eugene Brown, M.D.

  • Anesthesiology Physician
  • East Norriton, PA
  • NPI 1104933779
  Medicare reassignment Care Compare group NPD
• Yevgeny Chernyak, MD

  • Anesthesiology Physician
  • Havertown, PA
  • NPI 1699761247
  Medicare reassignment Care Compare group NPD
• Alexandre Geronian, MD

  • Psychiatry Physician
  • Pittsburgh, PA
  • NPI 1548443906
  Medicare reassignment Care Compare group NPD
• Piotr Krecioch, M.D.

  • Surgery Physician
  • Philadelphia, PA
  • NPI 1699074294
  Medicare reassignment Care Compare group NPD
• Ashley J Miller, D.O.

  • Family Medicine Physician
  • Plymouth Meeting, PA
  • NPI 1336464049
  Medicare reassignment Care Compare group NPD
• Johanna Owings, D.O.

  • Family Medicine Physician
  • Norristown, PA
  • NPI 1437312592
  Medicare reassignment Care Compare group NPD
• John Johghyun Park, MD

  • Anesthesiology Physician
  • Bristol, PA
  • NPI 1205862075
  Medicare reassignment Care Compare group NPD
• Chandra S K Reddy, MD

  • Orthopaedic Surgery Physician
  • Jim Thorpe, PA
  • NPI 1407870868
  Medicare reassignment Care Compare group NPD
• Alfred Schupp III, MD

  • Physical Medicine & Rehabilitation Physician
  • Malvern, PA
  • NPI 1699207407
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1710355029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 DEKALB PIKE",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194011820",
            "telephone_number": "610-278-2002",
            "fax_number": "610-272-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 DEKALB PIKE",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194011820",
            "telephone_number": "610-278-2002",
            "fax_number": "610-272-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-03",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry B. Stone, MD
• Daryl Elizabeth Stoner, M.D.
• Stony Creek Medical Sales
• Christine Elizabeth Strunk, D.O.
• Jennifer Sturtevant, SLP
• Super Tooth Pediatric Dentistry
• Divya Suresh
• Megan Sweeney, CRNP
• Christina Stengel Tabbut, CCC-SLP
• Sweta Tamang, MD

• Family Medicine Physician in East Norriton, PA
• Providers in East Norriton, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.