NPIMap

Temple Faculty Practice Plan, Inc

Organization Active NPI Urology Physician · Philadelphia, PA

NPI 1992288112 · NPPES record last updated Sep 13, 2018

Key facts

NPI
1992288112
Entity type
Organization (NPI type 2)
Primary specialty
Urology Physician 208800000X
Legal business name
TEMPLE FACULTY PRACTICE PLAN, INC
Practice address
3509 N Broad St
Philadelphia, PA 19140-4105
Phone
(215) 707-3375
Fax
(215) 707-4758
NPI assigned
Sep 13, 2018
Organization subpart
No

Authorized official

Name
Tonya Woodard
Title
Director Revenue Cycle
Phone
(215) 707-3911

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 46

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190208002623 PA Part B Supplier - Clinic/Group Practice 0345588711 Receives reassigned benefits from 2,095 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Locations

2705 DeKalb Pike
Ste 307
Norristown, PA 19401
Phone (610) 270-8344

8 Huntingdon Pike
Fl 3
Rockledge, PA 19046

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 208800000X Yes

Addresses

Primary practice location

3509 N Broad St
Philadelphia, PA 19140-4105

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-3375

Other practice location 1

255 S 17th St
Philadelphia, PA 19103-6231
Phone (215) 875-9710

Other practice location 2

7500 Central Ave
Philadelphia, PA 19111-2430
Phone (215) 707-3375

Other practice location 3

8380 Old York Rd
Elkins Park, PA 19027-1539
Phone (215) 707-3375

Other practice location 4

515 Pennsylvania Ave
Fort Washington, PA 19034-3314
Phone (215) 707-3375

Other practice location 5

4817-21 N Broad St
Philadelphia, PA 19141
Phone (215) 707-3375

Other names

  • Temple Faculty Urology Associates Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 13, 2018.

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536796800000",
    "number": "1992288112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-3375",
            "fax_number": "215-707-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105",
            "telephone_number": "215-707-3375",
            "fax_number": "215-707-4758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191036231",
            "country_code": "US",
            "telephone_number": "215-875-9710",
            "fax_number": "215-875-9714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7500 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191112430",
            "country_code": "US",
            "telephone_number": "215-707-3375",
            "fax_number": "215-707-4758",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8380 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Elkins Park",
            "state": "PA",
            "postal_code": "190271539",
            "country_code": "US",
            "telephone_number": "215-707-3375",
            "fax_number": "215-707-4758",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Washington",
            "state": "PA",
            "postal_code": "190343314",
            "country_code": "US",
            "telephone_number": "215-707-3375",
            "fax_number": "215-707-4758",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4817-21 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19141",
            "country_code": "US",
            "telephone_number": "215-707-3375",
            "fax_number": "215-707-4758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEMPLE FACULTY PRACTICE PLAN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE",
        "authorized_official_telephone_number": "215-707-3911"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temple Faculty Urology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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Sources for this page

Verify at the official NPI Registry.