PHILLIP MICHAEL KEMP BOHAN (MD) – Surgery Physician, NPI 1073043030
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,999 GENERAL SURGERY in PA
Provider Addresses for PHILLIP MICHAEL KEMP BOHAN (MD)
1800 Lombard Street
Room 206
Philadelphia, PA 191460000
Phone: (215) 615-2222
Type: Location
1800 LOMBARD STREET
ROOM 206
PHILADELPHIA, PA 191460000
Phone: (215) 615-2222
Type: Mailing
1 COOPER PLZ
CAMDEN, NJ 081031461
Phone: (856) 342-2000
Type: Location
735 Norman Dr Ste 3
Lebanon, PA 170427559
Phone: (717) 270-7908
Type: Location
Center for the Intrepid, 3551, Roger Brooke Drive, San Antonio, Bexar County, Texas, 78234, United States
MCHE-QD
FORT SAM HOUSTON, TX 782344505
Phone: (210) 916-2460
Type: Mailing
3551 ROGER BROOKE DRIVE, MCHE-QD
BROOKE ARMY MEDICAL CENTER
FORT SAM HOUSTON, TX 782344505
Phone: (210) 916-2460
Type: Location
1 FEDERAL ST STE 200
CAMDEN, NJ 081031088
Phone: (848) 288-6935
Fax: (732) 790-0107
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $70.
Total Amount is formed as General ($70) + Research ($0) + Ownership ($0) = $70.
Last reported payment date: 2023-08-08 • Largest payer in this snapshot: Prytime Medical Devices, Inc. ($70).
Total Amount
$70
General + Research + Ownership
Payments
2
Total payment records
General Amount
$70
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Prytime Medical Devices, Inc. | $70 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-08-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250825003535 | I | General Surgery | NJ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 19146)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery, Critical Care (Intensivists) | NJ | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | NJ | |
| General Surgery | NJ | |
| Physician Assistant | GA | |
| General Surgery | PA | |
| Nurse Practitioner | NJ | |
| General Surgery, Critical Care (Intensivists) | TX |
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