NPIMap

Individual provider Active NPI

Jason John Sanderson, D.O.

  • Family Medicine Physician
  • Fort Washington, PA
National Provider Identifier
1760444111
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS012064 Issued in PA
Practice address
515 Pennsylvania Ave Ste A2Nd
Fort Washington, PA 19034-3314
Phone
(215) 540-8408
Fax
(215) 540-8418
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS012064 PA Primary

Addresses

Primary practice location

515 Pennsylvania Ave Ste A2Nd
Fort Washington, PA 19034-3314

Mailing address

400 Cherry Tree Rd
Aston, PA 19014-2406
Phone (610) 485-6700

Other practice location 1

509 Germantown Pike
Lafayette Hill, PA 19444-1825
Phone (610) 828-7570

Other identifiers 2

IdentifierTypeStateIssuer
1031173500001MedicaidPA
DT0827OtherPARAILROAD MEDICARE PTAN

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
I20110804000208 PA Practitioner - Family Practice 4486823689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Temple Physicians IncGroup PAC ID 2062317233, 154 clinicians

Practice addresses (Care Compare)

515 Pennsylvania Ave a
Fort Washington, PA 19034-3317
Phone (215) 540-5408

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physicians Inc CurrentSince Mar 21, 2017 Accepting new patients
Temple Physicians Inc Family Medicine Current Accepting new patients
Temple Physicians Inc. Family Medicine Past Accepting new patients
Ware Medical Associates PastSince May 31, 2011 Accepting new patients
Temple Physicians Inc Family Medicine Past Accepting new patients

Locations

509 Germantown Pike
Lafayette Hl, PA 19444
Phone (610) 828-7570

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13566/brand/1/csg/1/fhir/r4

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 10

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1760444111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CHERRY TREE RD",
            "city": "ASTON",
            "state": "PA",
            "postal_code": "190142406",
            "telephone_number": "610-485-6700",
            "fax_number": "610-485-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PENNSYLVANIA AVE STE A2ND",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190343314",
            "telephone_number": "215-540-8408",
            "fax_number": "215-540-8418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 Germantown Pike",
            "address_purpose": "LOCATION",
            "city": "Lafayette Hill",
            "state": "PA",
            "postal_code": "194441825",
            "country_code": "US",
            "telephone_number": "610-828-7570",
            "fax_number": "610-941-3915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "JASON",
        "middle_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS012064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031173500001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DT0827",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, PA

Sources for this page

Verify at the official NPI Registry.