Individual provider Active NPI

Marc C Newman, MD

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1770529554
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD051852L Issued in PA
Practice address
3322 N Broad St
Department of Family and Community Medicine
Philadelphia, PA 19140-5185
Phone
(215) 707-4600
Fax
(215) 707-4034
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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 MD051852L PA Primary

Addresses

Primary practice location

3322 N Broad St
Department of Family and Community Medicine
Philadelphia, PA 19140-5185

Mailing address

2450 W Hunting Park Ave
3/208N
Philadelphia, PA 19129-1302
Phone (215) 707-5522

Other identifiers 1

IdentifierTypeStateIssuer
001786465MedicaidPA

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1770529554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "address_2": "3/208N",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-5522",
            "fax_number": "215-707-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 N BROAD ST",
            "address_2": "DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405185",
            "telephone_number": "215-707-4600",
            "fax_number": "215-707-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "MARC",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD051852L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001786465",
            "state": "PA"
        }
    ],
    "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 Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.