Individual provider Active NPI

Justen Kozlowski, DO

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1710563408
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS023853 Issued in PA
Practice address
800 Spruce St
Philadelphia, PA 19107-6192
Phone
(215) 316-5151
NPI assigned
Mar 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 010305 AZ
Internal Medicine Physician 207R00000X OS023853 PA Primary

Addresses

Primary practice location

800 Spruce St
Philadelphia, PA 19107-6192

Mailing address

800 Spruce St
Philadelphia, PA 19107-6192
Phone (215) 316-5151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, AZ2 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
I20240617001413 PA Practitioner - Internal Medicine 9931642154 Reassigns benefits to 1 organization
I20240628003418 AZ Practitioner - Internal Medicine 9931642154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie Col of Osteopathic Medicine, Bradenton, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 Spruce St FL 1 Pine W
Hospital Medicine Pah
Philadelphia, PA 19107-6130
Phone (215) 829-7817

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010305AZMDInternal Medicine Physician
OS023853PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health Syst Internal Medicine CurrentSince Jul 25, 2024 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 25, 2024 Accepting new patients
Signify Health, LLC CurrentSince May 17, 2024 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Internal Medicine Current Accepting new patients
The Pennsylvania Hospital of the University of Pennsylvania Health Sys Past Accepting new patients

Locations

2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246

800 Spruce St
#1W
Philadelphia, PA 19107
Phone (215) 829-7817

800 Spruce St
Fl 1
Philadelphia, PA 19107
Phone (215) 829-5873

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1710563408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076192",
            "telephone_number": "215-316-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076192",
            "telephone_number": "215-316-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOWSKI",
        "first_name": "JUSTEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "010305",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS023853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.