NPIMap

Individual provider Active NPI

Jason Pan, MD

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
National Provider Identifier
1851737035
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD464410 Issued in PA
Practice address
1800 Lombard St
Ground FL
Philadelphia, PA 19146-1414
Phone
(215) 893-2676
Fax
(215) 893-2610
NPI assigned
May 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 25MA10389800 NJ
Physical Medicine & Rehabilitation Physician 208100000X MD464410 PA Primary

Addresses

Primary practice location

1800 Lombard St
Ground FL
Philadelphia, PA 19146-1414

Mailing address

1800 Lombard St
Ground FL
Philadelphia, PA 19146-1414
Phone (215) 893-2676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180828003556 PA Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 6901156793 Reassigns benefits to 1 organization
I20180920000931 NJ Practitioner - Physical Medicine and Rehabilitation 6901156793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

1865 Route 70 East 220
Phys Med Rehab CH
Cherry Hill, NJ 08003-2013
Phone (856) 433-2641

800 Spruce St
Philadelphia, PA 19107-6130
Phone (215) 829-7923

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10389800NJMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Aug 5, 2018 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Clinical Health Care Associates of New Jersey, PC Current Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Aug 5, 2018 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 9, 2018 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 9, 2018 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

1865 Route 70 E
Ste 220
Cherry Hill, NJ 08003
Phone (856) 429-0505

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

1800 Lombard St
Fl 1
Philadelphia, PA 19146
Phone (215) 893-2600

3737 Market St
Fl 8
Philadelphia, PA 19104
Phone (215) 662-4333

1800 Lombard St
Philadelphia, PA 19146
Phone (215) 545-4173

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

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 and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1851737035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 LOMBARD ST",
            "address_2": "GROUND FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461414",
            "telephone_number": "215-893-2676",
            "fax_number": "215-893-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 LOMBARD ST",
            "address_2": "GROUND FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461414",
            "telephone_number": "215-893-2676",
            "fax_number": "215-893-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-15",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MA10389800",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD464410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.