Individual provider Active NPI

NA Rae Ju, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1871886119
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT199442 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104-4206
Phone
(215) 662-6305
NPI assigned
May 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT199442 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X MT199442 PA

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4206
Phone (215) 662-6305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, TX2 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
I20150811003709 DE Practitioner - Emergency Medicine 7911122312
I20190115001868 TX Practitioner - Emergency Medicine 7911122312 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.86 of 100Reported as group
Quality
92.78
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT199442PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of TX, PLLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Third Coast Emergency Physicians Southwest PA Emergency Medicine CurrentSince Dec 13, 2023 Accepting new patients
Tec Emergency Physicians, PLLC CurrentSince Dec 9, 2023 Accepting new patients
Okc Medical Stop LLC Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

134 Menger Spgs
Boerne, TX 78006
Phone (830) 331-3000

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

12412 Judson Rd
Live Oak, TX 78233
Phone (210) 646-5000

6402 Mallard Mdw
San Antonio, TX 78244
Phone (210) 757-5000

13434 Nacogdoches Rd
San Antonio, TX 78217
Phone (210) 447-7560

12805 W Interstate 10
San Antonio, TX 78249
Phone (210) 575-9805

11320 Alamo Ranch Pkwy
San Antonio, TX 78253
Phone (210) 485-3644

4103 N Loop 1604 W
San Antonio, TX 78249
Phone (210) 572-8415

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

9211 Potranco Rd
San Antonio, TX 78251
Phone (210) 575-9211

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

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": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1871886119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JU",
        "first_name": "NA",
        "middle_name": "RAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT199442",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT199442",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.