Individual provider Active NPI

Kenneth R Ginsburg

  • Pediatric Adolescent Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1871501684
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MD042906E Issued in PA
Practice address
3550 Market St FL 4
Chop Care Network at Market St - Adolescent Med
Philadelphia, PA 19104-3368
Phone
(215) 590-2178
Fax
(215) 590-4619
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD042906E PA
Pediatric Adolescent Medicine Physician 2080A0000X MD042906E PA Primary

Addresses

Primary practice location

3550 Market St FL 4
Chop Care Network at Market St - Adolescent Med
Philadelphia, PA 19104-3368

Mailing address

100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9234

Other identifiers 2

IdentifierTypeStateIssuer
001415144MedicaidPA
5536006MedicaidNJ

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
I20110225000045 PA Practitioner - Pediatric Medicine 3072794957 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD042906EPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Pediatrics CurrentSince Dec 10, 2010 Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Dec 10, 2010 Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients

Locations

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

3550 Market St
Fl 4
Philadelphia, PA 19104
Phone (215) 590-2178

Organizations & group practices 4

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1871501684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9234",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 MARKET ST FL 4",
            "address_2": "CHOP CARE NETWORK AT MARKET ST - ADOLESCENT MED",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043368",
            "telephone_number": "215-590-2178",
            "fax_number": "215-590-4619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINSBURG",
        "first_name": "KENNETH",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD042906E",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "PA",
            "license": "MD042906E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001415144",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5536006",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.