THOR SURG ASSOC OF FCCC, MGI
NPI 1073887154
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Philadelphia, PA

Q: What is the provider's specialty?

The provider's specialty is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Active since March 07, 2012

333 COTTMAN AVE, FOX CHASE CANCER CENTER, PHILADELPHIA, PA 19111(215) 728-6900(215) 728-2773 Get Directions Write a Review

NPPES record last updated: June 14, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Insurance Plans Accepted
Secondary Locations
Authorized Official
CLIA Information
Other Providers Same Location
Frequently Asked Questions

Organization
Thoracic Surgery (Cardiothoracic Vascula...
CLIA Number: 39D2008882
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 06-20-2026

About THOR SURG ASSOC OF FCCC, MGI

This page provides the complete NPI Profile along with additional information for Thor Surg Assoc Of Fccc, Mgi, a provider established in Philadelphia, Pennsylvania operating as a Thoracic Surgery (cardiothoracic Vascular Surgery). The healthcare provider is registered in the NPI registry with number 1073887154 assigned on March 2012. The practitioner's primary taxonomy code is 208G00000X. The provider is registered as an organization and their NPI record was last updated 8 years ago. Thor Surg Assoc Of Fccc, Mgi operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Thor Surg Assoc Of Fccc, Mgi. The authorized official of this NPI record is Tonya Woodard (Credentialing/manager)

NPI: 1073887154 Verify this NPI
Provider Legal Name: FOX CHASE CANCER CENTER MEDICAL GROUP, INC
Other Organization Name: THOR SURG ASSOC OF FCCC, MGI
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 333 COTTMAN AVE FOX CHASE CANCER CENTER PHILADELPHIA, PA 19111
Location Phone: (215) 728-6900
Location Fax: (215) 728-2773
Mailing Address: 2450 W HUNTING PARK AVE PHILADELPHIA, PA 19129
Mailing Phone: (215) 728-6900
Mailing Fax: (215) 728-2773
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 03-07-2012
Last Update Date: 06-14-2018
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Location Map

Secondary Locations

2701 Dekalb Pike
Norristown, PA 19401
(888) 369-2487
2365 Heritage Center Dr
Furlong, PA 18925
(215) 728-6900

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery)
Taxonomy Code: 208G00000X
Type: Allopathic & Osteopathic Physicians
Taxonomy Description: A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: TONYA WOODARD
Authorized Official Title: CREDENTIALING/MANAGER
Authorized Official Phone: (215) 707-3911

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State
1026888280035	MEDICAID (05)	PA
1026888280025	MEDICAID (05)	PA
1026888280006	MEDICAID (05)	PA

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 39D2008882
Facility Type: Physician Office
Certificate Effective Date: June 21, 2024
Certificate Expiration Date: June 20, 2026
Laboratory Director: DR. SHELLY B. HAYES
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Thor Surg Assoc Of Fccc, Mgi to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.