Individual provider Active NPI

Gregory Edward Supple, MD

  • Clinical Cardiac Electrophysiology Physician
  • Philadelphia, PA
National Provider Identifier
1881720563
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
MD436470 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104-4206
Phone
(215) 662-7355
Fax
(215) 349-8444
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X MD436470 PA Primary
Cardiovascular Disease Physician 207RC0000X MD436470 PA

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4206
Phone (215) 662-7355

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
I20090709000228 PA Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0345392197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Perelman School of Med at the University of Pennsylvania, 2005
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)

1001 Chesterbrook Blvd 3Rd FL W
Penn Cardiac Electrophysiology
Berwyn, PA 19312-3805
Phone (215) 662-3999

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127
Phone (215) 615-4949

3400 Civic Ctr Blvd W Pavillion
Penn Vad Transplant Perelman
Philadelphia, PA 19104-5127
Phone (215) 662-2019

501 S 54TH St
Penn Cardiology Hup Cedar Ave
Philadelphia, PA 19143-1900
Phone (215) 662-7355

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-9801

51 N 39TH St HVP 2ND FL
Div of Cardiology
Philadelphia, PA 19104-2640
Phone (215) 662-9010

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Jul 1, 2012 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Aug 18, 2014 Accepting new patients
University of Penn - Medical Group Cardiovascular Disease CurrentSince Jul 1, 2012 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Aug 18, 2014 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Cardiovascular Disease Past Accepting new patients

Locations

1001 Chesterbrook Blvd
Fl 3W
Berwyn, PA 19312

1001 Chesterbrook Blvd
Fl 3E
Berwyn, PA 19312

3400 Spruce St
Fl 9
Philadelphia, PA 19104
Phone (215) 662-2891

3400 Civic Center Blvd
Ste 2E
Philadelphia, PA 19104
Phone (215) 615-0820

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

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

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 5

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 6

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1881720563",
    "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": "215-662-7355",
            "fax_number": "215-349-8444"
        },
        {
            "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": "215-662-7355",
            "fax_number": "215-349-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPPLE",
        "first_name": "GREGORY",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "PA",
            "license": "MD436470",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD436470",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.