Active NPI
Peter Michael Jucovy, MD
- Anatomic Pathology Physician
- Philadelphia, PA
National Provider Identifier
1750891362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- MD020043E
- Practice address
- 7414 Crittenden St
Philadelphia, PA 19119-1015 - Phone
- (215) 242-6140
- NPI assigned
- Oct 9, 2017
- 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 |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | MD020043E | PA | Primary |
Addresses
Primary practice location
7414 Crittenden St
Philadelphia, PA 19119-1015
Mailing address
7414 Crittenden St
Philadelphia, PA 19119-1015
Phone (215) 242-6140
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 |
|---|---|---|---|
| MD020043E | PA | MD | Anatomic Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1750891362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7414 CRITTENDEN ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191191015",
"telephone_number": "215-242-6140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7414 CRITTENDEN ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191191015",
"telephone_number": "215-242-6140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUCOVY",
"first_name": "PETER",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-09",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "PA",
"license": "MD020043E",
"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 Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.