Suburban Plastic Surgeons PC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

MD043562L Issued in PA

Legal business name

SUBURBAN PLASTIC SURGEONS PC

Practice address

1250 Greenwood Ave
Suite 14
Jenkintown, PA 19046-2902

Phone

(215) 572-6888

Fax

(215) 572-5905

NPI assigned

May 22, 2006

Organization subpart

No

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

Authorized official

Name

Charles David Long, MDNPI 1033164736

Title

Pres Owner

Phone

(215) 572-6888

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 3

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

• Charles David Long, MD

  • Plastic Surgery Physician
  • Jenkintown, PA
  • NPI 1033164736
  Medicare reassignment Authorized official
• Jamie Kay Tamburino, MSN, CRNP,CWOCN

  • Adult Health Clinical Nurse Specialist
  • Abington, PA
  • NPI 1306111810
  NPD (past)
• Mark Granick, MD

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Newark, NJ
  • NPI 1235239328
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1992759997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 GREENWOOD AVE",
            "address_2": "SUITE 14",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462902",
            "telephone_number": "215-572-6888",
            "fax_number": "215-572-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 GREENWOOD AVE",
            "address_2": "SUITE 14",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462902",
            "telephone_number": "215-572-6888",
            "fax_number": "215-572-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN PLASTIC SURGEONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRES  OWNER",
        "authorized_official_telephone_number": "215-572-6888",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD043562L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN",
            "identifier": "0016511000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "052949",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE",
            "identifier": "052949",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018274790004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Michael Stone
• Boryana S Stoyanova, DMD
• Mortimer James Strong, D.O.
• Suburban Chest Associates, P.C.
• Suburban Eye Associates, PC
• Sunshine Healing & Counseling
• Susan Joy Meller DO PC
• Susan L. Beebe, PH.D.
• Susan M Leoni DMD
• Neal B. Suway, D.D.S.

• Plastic Surgery Physician in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• Plastic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.