Individual provider Active NPI

Robert O Detweiler, DO

  • Family Medicine Physician
  • Lansdale, PA
National Provider Identifier
1790751246
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS005844L Issued in PA
Practice address
1970 North Broad Street
Lansdale, PA 19446-1002
Phone
(215) 368-1900
Fax
(215) 368-8772
NPI assigned
Feb 24, 2006
Last updated
Oct 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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 OS005844L PA Primary

Addresses

Primary practice location

1970 North Broad Street
Lansdale, PA 19446-1002

Mailing address

1970 North Broad Street
Lansdale, PA 19446
Phone (215) 368-1900

Other identifiers 1

IdentifierTypeStateIssuer
129258101MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110204000307 PA Practitioner - Family Practice 8628170669 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health Syst Family Medicine CurrentSince Jul 11, 2023 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 11, 2023 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Family Medicine Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Silver Stream Nursing and Rehab Facility LLC Past Accepting new patients
Harborview Rehabilitation and Care Center at Lansdale LLC Past Accepting new patients

Locations

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1790751246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 NORTH BROAD STREET",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "19446",
            "telephone_number": "215-368-1900",
            "fax_number": "215-368-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 NORTH BROAD STREET",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194461002",
            "telephone_number": "215-368-1900",
            "fax_number": "215-368-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWEILER",
        "first_name": "ROBERT",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS005844L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129258101",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

Sources for this page

Verify at the official NPI Registry.