JEFFERSON UNIVERSITY PHYSCIANS (NPI# 1588136055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588136055 |
| Entity Type | Organization |
| Organization Name | JEFFERSON UNIVERSITY PHYSCIANS |
| Practice Address |
1020 Sansom St Fl 10 Philadelphia PA 19107-5002 |
| Mailing Address |
615 Chestnut St Fl 14 Philadelphia PA 19106-4404 |
| Practice Telephone | 2159556844 |
| Practice Fax Number | 2159552526 |
| Mailing Telephone | 2155037543 |
| Mailing Fax Number | 2159552420 |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2018-12-21 |
| Authorized Official Name | VALERIE YVETTE BRIGHT-BUTLER (ASSOCIATE DIRECTOR, CREDENTIALING) |
| Authorized Official Telephone | 2159559451 |
| Is Organization Subpart | Y |
| Parent Organization Name | JEFFERSON UNIVERSITY PHYSCIANS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jefferson Observation Physicians | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912477324 | Jefferson University Physcians | Internal Medicine | 3 Crescent Dr Fl 2, Philadelphia, PA 19112-1016 | 2018-11-28 |
| 1508031287 | Jefferson University Physcians | Anesthesiology | 833 Chestnut St, Suite 630, Philadelphia, PA 19107-4414 | 2008-04-24 |
| Street Address |
1020 SANSOM ST FL 10 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-5002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891254744 | Neil Leon Darby | Emergency Medicine | 706a S Colorado St, Philadelphia, PA 19146-1915 | 2019-03-19 |
| 1023515384 | Lisa Michelle Friedland | Emergency Medicine | 1020 Sansom St, Suite 1651b, Philadelphia, PA 19107 | 2018-04-11 |
| 1326543034 | Daniel Du Pont | Emergency Medicine | 3400 Civic Center Blvd Bldg 421, Philadelphia, PA 19104 | 2018-03-26 |
| 1053827485 | Prohealth Leaders LLC | Emergency Medicine | 9963 Bustleton Ave, Philadelphia, PA 19115-1557 | 2017-12-21 |
| 1841729340 | Mark Ramzy | Emergency Medicine | 230 North Broad St, Hahnemann University Hospital, Philadelphia, PA 19102 | 2017-06-08 |
| 1871020347 | Benjamin Ariel Bloom | Emergency Medicine | 1316 W Ontario St Fl 10, Philadelphia, PA 19140-5220 | 2017-05-16 |
| 1730575283 | Elaine Smith | Emergency Medicine | 1020 Sansom St Ste 1651b, Philadelphia, PA 19107-5002 | 2015-04-11 |
| 1295120251 | Stephen Hallisey | Emergency Medicine | 3400 Spruce St Hospital of The University of Pa, Department of Emergency Medicine Ground Floor Ravdin, Philadelphia, PA 19104-4238 | 2015-04-06 |
| 1831505254 | Gerald Whelan | Emergency Medicine | 39 Summit St, Philadelphia, PA 19118-2832 | 2014-07-07 |
| 1679987374 | John Benjamin | Emergency Medicine | 245 N. 15th Street, Philadelphia, PA 19102 | 2014-06-20 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.