NPIMap

Individual provider Active NPI

Jack Ende, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1730110412
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD044127 Issued in PA
Practice address
51 N 39TH St
Philadelphia, PA 19104
Phone
(215) 662-9990
Fax
(215) 662-3127
NPI assigned
Jul 5, 2006
Last updated
Feb 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD044127 PA Primary

Addresses

Primary practice location

51 N 39TH St
Philadelphia, PA 19104

Mailing address

51 N 39TH St
Philadelphia, PA 19104-2640

Other identifiers 1

IdentifierTypeStateIssuer
0011742920001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110202000540 PA Practitioner - HospitalistPractitioner - Internal Medicine 9436233004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3801 Filbert St
Penn Center for Primary Care
Philadelphia, PA 19104-2640
Phone (215) 662-9990

3801 Filbert St Mab
102 Penn Center for Primary Care
Philadelphia, PA 19104-2640
Phone (215) 662-9990

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-9436

51 N 39TH Street Mab
Philadelphia, PA 19104-2640
Phone (215) 662-9990

51 N 39TH Stret
Hospital Med Presby
Philadelphia, PA 19104-2640
Phone (215) 662-9990

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD044127PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Internal Medicine Current Accepting new patients
Trustees of the University of Pennsylvania Internal Medicine CurrentSince Mar 31, 2024 Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Presbyterian Medical Center of the University of Pennsylvania Health S PastSince Nov 6, 2000 Accepting new patients

Locations

3400 Spruce St
Fl 6
Philadelphia, PA 19104
Phone (215) 615-0800

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3701 Market St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-2250

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Penn Presbyterian Medical CenterPhiladelphia, PA, CCN 390223 Hospital Corporate Director Nov 6, 2000
Penn Medicine Home HealthBala Cynwyd, PA, CCN 397125 Home health agency Corporate Director Nov 6, 2000

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1730110412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-9990",
            "fax_number": "215-662-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDE",
        "first_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD044127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011742920001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.