Active NPI
Barry Bub, MD
- Family Medicine Physician
- Philadelphia, PA
National Provider Identifier
1740697663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 002172
- Practice address
- 115 E Roumfort Rd
Unit 16
Philadelphia, PA 19119-1655 - Phone
- (914) 500-5698
- NPI assigned
- Jul 14, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 002172 | PA | Primary |
Addresses
Primary practice location
115 E Roumfort Rd
Unit 16
Philadelphia, PA 19119-1655
Mailing address
115 E Roumfort Rd
Unit 16
Philadelphia, PA 19119-1655
Phone (914) 500-5698
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002172 | PA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405296000000",
"number": "1740697663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 E ROUMFORT RD",
"address_2": "UNIT 16",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191191655",
"telephone_number": "914-500-5698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 E ROUMFORT RD",
"address_2": "UNIT 16",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191191655",
"telephone_number": "914-500-5698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUB",
"first_name": "BARRY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-14",
"last_updated": "2014-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "002172",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.