NPIMap

Organization Active NPI

Temple Physicians Inc.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1740332048
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TEMPLE PHYSICIANS INC.
Practice address
9892 Bustleton Ave Ste 101
Philadelphia, PA 19115-2138
Phone
(215) 676-2741
Fax
(215) 676-2796
NPI assigned
Jan 17, 2007
Last updated
May 2, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
TEMPLE PHYSICIANS INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Authorized official

Name
Richard Vaughn
Title
Lead Cred Specialist
Phone
(215) 926-9019

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

9892 Bustleton Ave Ste 101
Philadelphia, PA 19115-2138

Mailing address

PO Box 820933
Philadelphia, PA 19182-0933
Phone (215) 926-9000

Other practice location 1

9922 Roosevelt Blvd
Suite 1A
Philadelphia, PA 19115-1705
Phone (215) 676-2741

Other identifiers 8

IdentifierTypeStateIssuer
CD4829OtherPARRM
30033849OtherPAKEYSTONE MERCY
5561583OtherPAAETNA PPO
0000201OtherPAAETNA HMO
0756985039OtherPAIBC (KHPE & PC)
1961997OtherPAHIGHMARK BLUE SHIELD
01927OtherPAHEALTH PARTNERS SITE #
100727800MedicaidPA

Other names 2

  • Temple Internal Medicine Northeast Other name
  • Temple Physicians at Red Lion Plaza Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000054 PA Part B Supplier - Clinic/Group Practice 2062317233 Receives reassigned benefits from 494 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2116825Temple Internal Medicine Northeast9892 Bustleton Ave, Suite 101, Philadelphia, PA 19115Certificate of waiverMay 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Temple Physicians Inc C77 organizations share this tax ID, including this one
Part of
Temple Physicians Inc C

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

9892 Bustleton Ave
Ste 101
Philadelphia, PA 19115
Phone (215) 464-7711

9922 Roosevelt Blvd
Ste 1A
Philadelphia, PA 19115
Phone (215) 464-6040

8 Huntingdon Pike
Ste 100
Rockledge, PA 19046
Phone (215) 663-8880

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1740332048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820933",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191820933",
            "telephone_number": "215-926-9000",
            "fax_number": "215-226-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9892 BUSTLETON AVE STE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152138",
            "telephone_number": "215-676-2741",
            "fax_number": "215-676-2796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9922 Roosevelt Blvd",
            "address_2": "Suite 1A",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191151705",
            "country_code": "US",
            "telephone_number": "215-676-2741",
            "fax_number": "215-676-2796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEMPLE PHYSICIANS INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TEMPLE PHYSICIANS INC.",
        "enumeration_date": "2007-01-17",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "LEAD CRED SPECIALIST",
        "authorized_official_telephone_number": "215-926-9019"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "CD4829",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30033849",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5561583",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "0000201",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC (KHPE & PC)",
            "identifier": "0756985039",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1961997",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS SITE #",
            "identifier": "01927",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100727800",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temple Internal Medicine Northeast",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Temple Physicians at Red Lion Plaza",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Temple Physicians at Red Lion Plaza",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.