Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jack H Mydlo, MD

Individual provider Urology Physician · NPI 1780672881

Jack H Mydlo, MD is an Urology in Philadelphia, Pennsylvania. Graduated from State University of Ny Upstate Medical University in 1981, 45 years ago. Practices with Temple Faculty Practice Plan Inc, a 1,314-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Pennsylvania.

Years since qualifying
45
Trained at
State University of Ny Upstate Medical University
Licensed in
PA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3401 N Broad St 3rd Fl Parkinson Pavilion
Philadelphia, PA 19140-5103
Phone: (215) 707-3375
Fax: (215) 707-4758
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence MD071004L (PA)

Record details

NPI number1780672881
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 12, 2005
Last updated in NPPESMarch 21, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolSTATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated 1981 (45 years in practice)
Group practice Temple Faculty Practice Plan Inc — 1314 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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