Individual provider Active NPI

Stanley J Travis Jr., DO

  • Family Medicine Physician
  • Hatboro, PA
National Provider Identifier
1902967797
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0S002173L Issued in PA
Practice address
501 Buckman Drive
Hatboro, PA 19040-1402
Phone
(215) 672-6878
Fax
(215) 672-6812
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0S002173L PA Primary

Addresses

Primary practice location

501 Buckman Drive
Hatboro, PA 19040-1402

Mailing address

501 Buckman Drive
Hatboro, PA 19040-1402
Phone (215) 672-6878

Other identifiers 1

IdentifierTypeStateIssuer
0060654401OtherPAMEDICAL ASSISTANCE

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
I20100521000386 PA Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 4385773803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Philadelphia College of Osteopathic Medicine, 1964
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

501 Buckman Dr
Hatboro, PA 19040-1402
Phone 215672687778

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0S002173LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanley J. Travis, Jr, D.O., P.C. Family Medicine CurrentSince Oct 1, 1984 Accepting new patients

Locations

501 Buckman Dr
Hatboro, PA 19040
Phone (215) 672-6877

Organizations & group practices 1

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 4

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1902967797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BUCKMAN DRIVE",
            "city": "HATBORO",
            "state": "PA",
            "postal_code": "190401402",
            "telephone_number": "215-672-6878",
            "fax_number": "215-672-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BUCKMAN DRIVE",
            "city": "HATBORO",
            "state": "PA",
            "postal_code": "190401402",
            "telephone_number": "215-672-6878",
            "fax_number": "215-672-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "STANLEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "0S002173L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "0060654401",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hatboro, PA

Sources for this page

Verify at the official NPI Registry.