NPIMap

Organization Active NPI

Health Services of FCCC

Doing business as Anesthesia Assoc of FCCC

  • Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1790752707
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
HEALTH SERVICES OF FCCC
Doing business as
Anesthesia Assoc of FCCC
Practice address
333 Cottman Avenue
Fox Chase Cancer Center
Philadelphia, PA 19111
Phone
(215) 728-6900
NPI assigned
Mar 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Authorized official

Name
Jennifer Green
Title
Credentialing Manager
Phone
(215) 728-2697

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

333 Cottman Avenue
Fox Chase Cancer Center
Philadelphia, PA 19111

Mailing address

333 Cottman Avenue
Medical Staff Office
Philadelphia, PA 19111
Phone (215) 728-6900

Other identifiers 1

IdentifierTypeStateIssuer
1007736990006MedicaidPA

Other names 1

  • Anesthesia Assoc of FCCC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Health Services of Fox Chase Cancer Center10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

333 Cottman Ave
Ofc
Philadelphia, PA 19111
Phone (215) 214-1405

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1790752707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19111",
            "telephone_number": "215-728-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVENUE",
            "address_2": "FOX CHASE CANCER CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19111",
            "telephone_number": "215-728-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH SERVICES OF FCCC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "215-728-2697"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007736990006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anesthesia Assoc of FCCC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 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.