Individual provider Active NPI

Jason Grey Faulkenberry, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1912226580
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
100211 Issued in GA
Practice address
3401 Civic Center Blvd
Department of Biomedical and Health Informatics
Philadelphia, PA 19104
Phone
(267) 425-1663
NPI assigned
May 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD466580 PA
Pediatrics Physician 208000000X MD466580 PA
Pediatrics Physician 208000000X 100211 GA
Internal Medicine Physician 207R00000X 100211 GA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Department of Biomedical and Health Informatics
Philadelphia, PA 19104

Mailing address

1929 Morrison Dr
Decatur, GA 30033-5372
Phone (786) 571-6384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, GA2 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
I20210525003455 PA Practitioner - NephrologyPractitioner - Internal Medicine 9436463353 Reassigns benefits to 4 organizations
I20250828001795 GA Practitioner - HospitalistPractitioner - Pediatric Medicine 9436463353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Pediatric Medicine
Education
Eastern Virginia Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians
Fayette Physician Network IncGroup PAC ID 3375865819, 309 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

500 W Berkeley St
Uniontown, PA 15401-5514
Phone (724) 430-6899

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD466580PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince May 17, 2023 Accepting new patients
The Emory Clinic Inc Internal Medicine CurrentSince Aug 13, 2025 Accepting new patients
Fayette Physician Network Inc Internal Medicine CurrentSince Jun 16, 2025 Accepting new patients
Childrens Health Care Associates, Inc CurrentSince Apr 16, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2021 Accepting new patients
University of Penn - Medical Group Internal Medicine Current Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Fayette Physician Network Inc CurrentSince Jun 16, 2025 Accepting new patients
University of Pittsburgh Physicians CurrentSince May 17, 2023 Accepting new patients
University of Penn-Medical Group Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Apr 16, 2023 Accepting new patients
Crawford Long Hospital Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

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

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

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

500 W Berkeley St
Uniontown, PA 15401
Phone (724) 430-5000

201 Mary Higginson Ln
Uniontown, PA 15401
Phone (724) 430-5940

Interoperability endpoints

  • Direct secure messaging: jfaulkenberry1187368@direct.emory.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 3

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": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1912226580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 MORRISON DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335372",
            "telephone_number": "786-571-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DEPARTMENT OF BIOMEDICAL AND HEALTH INFORMATICS",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "267-425-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKENBERRY",
        "first_name": "JASON",
        "middle_name": "GREY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-21",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD466580",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD466580",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "100211",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "100211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.