Provider Demographics
NPI:1427388511
Name:INSTITUTE FOR SPINAL SURGERY INC
Entity type:Organization
Organization Name:INSTITUTE FOR SPINAL SURGERY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-353-5079
Mailing Address - Street 1:2000 SPROUL RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3509
Mailing Address - Country:US
Mailing Address - Phone:610-353-5079
Mailing Address - Fax:484-427-8103
Practice Address - Street 1:2000 SPROUL RD
Practice Address - Street 2:SUITE 320
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3509
Practice Address - Country:US
Practice Address - Phone:610-353-5079
Practice Address - Fax:484-427-8103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD424663207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000000308051OtherUNISON
DE1427388511OtherDELAWARE MEDICAL ASSISTANCE-DIAMOND STATE PARTNERS
DE1427388511OtherDELAWARE PHYSICIANS CARE
DE30-0419452OtherMULTIPLAN
DE30-0419452OtherDELAWARE WORKER'S COMPENSATION
PA30-0419452OtherDEVON
PA3774906000OtherINDEPENDENCE BLUE CROSS (PERSONAL CHOICE, KHPE, FEDERAL, AMERIHEALTH)
DE1427388511OtherDELAWARE BLUE CROSS BLUE SHIELD
PA1631494OtherHIGHMARK BLUE SHIELD
DE30-0419452OtherFIRST HEALTH NETWORK
PA30-0419452OtherCIGNA
PA102536817 0001Medicaid
DE30-0419452OtherCIGNA
PA30-0419452OtherMULTIPLAN
PA30-0419452OtherTRICARE
DE30-0419452OtherDEVON HEALTH
PA30076177OtherKEYSTONE MERCY
PA1427388511OtherAETNA
DE2522492OtherHIGHMARK BLUE SHIELD
PA30-0419452OtherFIRST HEALTH NETWORK
DE30-0419452OtherUNITED HEALTHCARE
PA30-0419452OtherUNITED HEALTHCARE
PA30-0419452OtherTRICARE
DE1427388511OtherDELAWARE MEDICAL ASSISTANCE-DIAMOND STATE PARTNERS