Jack Michael Becker, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

MDO42717E Issued in PA

Practice address

233 E Lancaster Ave Ste 200
Ardmore, PA 19003

Phone

(610) 642-1643

NPI assigned

May 4, 2006

Last updated

May 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Allergy/Immunology

Education

Temple University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line Allergy , L.L.P.Group PAC ID 0941284301, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IIEIBA
• Direct secure messaging: jack.becker@mainlineallergy.eclinicaldirectplus.com

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.

• Main Line Allergy , L.L.P.

  • Allergy & Immunology Physician
  • Ardmore, PA
  • NPI 1437104460
  Medicare reassignment Care Compare group NPD
• STC Pediatrics LLC

  dba St. Christopher's Pediatric Associates Emergency Medicine - E. Erie A

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Philadelphia, PA
  • NPI 1144864547
  Medicare reassignment NPD
• STC Pediatrics LLC

  dba St. Christopher's Pediatric Associates Ophthalmology - Newtown Yardley

  • Ophthalmology Physician
  • Newtown, PA
  • NPI 1548141997
  NPD
• STC Pediatrics LLC

  dba St. Christopher's Pediatric Associates Neurology - E. Erie Avenue

  • Neurology with Special Qualifications in Child Neurology Physician
  • Philadelphia, PA
  • NPI 1578107926
  NPD
• SCHC Pediatric Associates, LLC

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1255363578
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1851349955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E LANCASTER AVE STE 200",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "19003",
            "telephone_number": "610-642-1643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 E Erie Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191341011",
            "country_code": "US",
            "telephone_number": "215-427-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECKER",
        "first_name": "JACK",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "PA",
            "license": "MDO42717E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001252808",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK PIN",
            "identifier": "673732",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra S Bartlett, M.D.
• Michael Bartolomucci, DPT
• Leah Bayuk
• Beabb
• Janet L Beausoleil
• Maureen E Becker
• Leilani Bell, PHD
• Jeffrey Allen Bellisario, DDS
• Alene Bender Herman, MSN, CRNP
• Howard J Benjamin, D.C.

• Allergy & Immunology Physician in Ardmore, PA
• Providers in Ardmore, PA by specialty
• Allergy & Immunology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.