Individual provider Active NPI

Benjamin Nussbaum Fogel, M.D.

  • Pediatrics Physician
  • Hershey, PA
National Provider Identifier
1881824191
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD451777 Issued in PA
Practice address
35 Hope Dr Ste 102
Hershey, PA 17033-2086
Phone
(717) 531-7300
Fax
(717) 531-3527
NPI assigned
Jul 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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 250822 MA
Pediatrics Physician 208000000X MD451777 PA Primary

Addresses

Primary practice location

35 Hope Dr Ste 102
Hershey, PA 17033-2086

Mailing address

PO Box 858
Hershey, PA 17033-0858
Phone (800) 243-1455

Other identifiers 2

IdentifierTypeStateIssuer
MD451777OtherPAMEDICAL LICENSE
1029757460001MedicaidPA

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
I20141210001536 PA Practitioner - Pediatric Medicine 9537305909 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD451777PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physicians Group Pediatrics CurrentSince Oct 11, 2014 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Oct 11, 2014 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
The Milton S. Hershey Medical Center Physicians Group Past Accepting new patients

Locations

35 Hope Dr
Hershey, PA 17033
Phone (717) 531-3503

35 Hope Dr
Ste 104
Hershey, PA 17033
Phone (717) 531-5160

35 Hope Dr
Ste 102
Hershey, PA 17033
Phone (717) 531-7300

35 Hope Dr
Ste 102104
Hershey, PA 17033
Phone (717) 531-5160

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

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": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1881824191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 HOPE DR STE 102",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332086",
            "telephone_number": "717-531-7300",
            "fax_number": "717-531-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGEL",
        "first_name": "BENJAMIN",
        "middle_name": "NUSSBAUM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-21",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "250822",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD451777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD451777",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029757460001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.