Individual provider Active NPI

Charles W Schwab, MD

  • Surgical Critical Care Physician
  • Philadelphia, PA
National Provider Identifier
1821034059
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
MD038757E Issued in PA
Practice address
3400 Spruce Street
2 Dulles
Philadelphia, PA 19104
Phone
(215) 662-7320
Fax
(215) 243-4605
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD038757E PA
Trauma Surgery Physician 2086S0127X MD038757E PA
Surgical Critical Care Physician 2086S0102X MD038757E PA Primary

Addresses

Primary practice location

3400 Spruce Street
2 Dulles
Philadelphia, PA 19104

Mailing address

3400 Spruce Street
2 Dulles
Philadelphia, PA 19104
Phone (215) 662-7320

Other identifiers 1

IdentifierTypeStateIssuer
0011139200001MedicaidPA

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
I20070730000513 PA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 3577664960 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD038757EPAMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Feb 1, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince Feb 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients

Locations

3400 Spruce St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-2050

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

3400 Spruce St
#818
Philadelphia, PA 19104

3400 Spruce St
Fl 5
Philadelphia, PA 19104
Phone (215) 662-2777

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1821034059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "2 DULLES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-7320",
            "fax_number": "215-243-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "2 DULLES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-7320",
            "fax_number": "215-243-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWAB",
        "first_name": "CHARLES",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD038757E",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "PA",
            "license": "MD038757E",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "PA",
            "license": "MD038757E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011139200001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.