Individual provider Active NPI

Justin Bradley Ziemba, MD

  • Urology Physician
  • Philadelphia, PA
National Provider Identifier
1861710865
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD451958 Issued in PA
Practice address
3400 Civic Center Blvd FL 3
Philadelphia, PA 19104-5127
Phone
(215) 662-2065
NPI assigned
May 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X D0079061 MD
Urology Physician 208800000X MD451958 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd FL 3
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
3Rd FL West
Philadelphia, PA 19104-5127
Phone (215) 662-2065

Other identifiers 1

IdentifierTypeStateIssuer
097099900MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171024000164 NJ Practitioner - Urology 9638480122 Reassigns benefits to 1 organization
I20171024000259 PA Practitioner - Urology 9638480122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Perelman School of Med at the University of Pennsylvania, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

1865 Route 70 E 210
Uro Cherry Hill
Cherry Hill, NJ 08003-2013
Phone (215) 662-2891

3737 Market St
FL 4
Philadelphia, PA 19104-5544
Phone (215) 662-8699

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0079061MDMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Aug 27, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince Aug 26, 2017 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Aug 27, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince Aug 26, 2017 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Urology Current Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

1865 Route 70 E
Ste 210
Cherry Hill, NJ 08003
Phone (856) 427-4336

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

3400 Civic Center Blvd
Fl 3
Philadelphia, PA 19104
Phone (215) 614-4100

3737 Market St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-8664

800 Walnut St
Fl 19
Philadelphia, PA 19107
Phone (215) 829-3409

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

3400 Civic Center Blvd
Fl 3W
Philadelphia, PA 19104

3400 Civic Center Blvd
#2W
Philadelphia, PA 19104
Phone (215) 614-1618

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

Organizations & group practices 9

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": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861710865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "3RD FL WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEMBA",
        "first_name": "JUSTIN",
        "middle_name": "BRADLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MD",
            "license": "D0079061",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD451958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097099900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.