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219 N Broad St Fl 6 Philadelphia PA 19107-1519 | |
| (610) 743-7026 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 219 N Broad St Fl 6, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Robert Ehinger (SR VP FINANCIAL OPERATIONS) |
| Authorized Official Contact | 4846284681 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 13579 Reading PA 19612-3579 Ph: (610) 743-6049 | 219 N Broad St Fl 6 Philadelphia PA 19107-1519 Ph: (610) 743-7026 |
| NPI Number | 1780227488 |
|---|---|
| Provider Enumeration Date | 10/25/2019 |
| Last Update Date | 11/20/2021 |
| Medicare PECOS PAC ID | 9335147784 |
|---|---|
| Medicare Enrollment ID | O20061117000409 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780227488 | NPI | - | NPPES |
| 3400P26 | Other | MC ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
| Provider Name | Wei Du |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467552943 PECOS PAC ID: 0446156947 Enrollment ID: I20031208000257 |
| Provider Name | Jeffrey David Bedrick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174573869 PECOS PAC ID: 9335197284 Enrollment ID: I20050106000837 |
| Provider Name | Janet Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124072582 PECOS PAC ID: 6901855907 Enrollment ID: I20050118000042 |
| Provider Name | Seema Baranwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386607224 PECOS PAC ID: 4183674872 Enrollment ID: I20050131000522 |
| Provider Name | Nielufar Varjavand |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316990369 PECOS PAC ID: 1456390137 Enrollment ID: I20050502001139 |
| Provider Name | Mary Ann Kuzma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083662308 PECOS PAC ID: 7012944044 Enrollment ID: I20050721000526 |
| Provider Name | Judith Ellen Wolf |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972554624 PECOS PAC ID: 4688688823 Enrollment ID: I20060126000920 |
| Provider Name | Zhabiz Kazeminezhad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407865298 PECOS PAC ID: 1850395328 Enrollment ID: I20060914000475 |
| Provider Name | Jennifer Lynn Hamilton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013936491 PECOS PAC ID: 8426153701 Enrollment ID: I20070416000050 |
| Provider Name | Reem A Tarazi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598983645 PECOS PAC ID: 6002914579 Enrollment ID: I20070606000530 |
| Provider Name | Annette B Gadegbeku |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063625176 PECOS PAC ID: 2668568353 Enrollment ID: I20071010000674 |
| Provider Name | Barry Brent Simmons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336366467 PECOS PAC ID: 8224109152 Enrollment ID: I20080619000384 |
| Provider Name | Steven L Zinn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376589168 PECOS PAC ID: 6305976309 Enrollment ID: I20100618000280 |
| Provider Name | Kathleen F Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427004605 PECOS PAC ID: 5395875280 Enrollment ID: I20100621000398 |
| Provider Name | Julieanne Hlavac |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235179714 PECOS PAC ID: 0648301531 Enrollment ID: I20100621000557 |
| Provider Name | Nathalie S May |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922051515 PECOS PAC ID: 3274664149 Enrollment ID: I20100622000516 |
| Provider Name | Pamela M Duke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285687855 PECOS PAC ID: 3072645225 Enrollment ID: I20100723000163 |
| Provider Name | Rita Shaughnessy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548297906 PECOS PAC ID: 3173656394 Enrollment ID: I20100809000272 |
| Provider Name | Barbara A Schindler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205871381 PECOS PAC ID: 1850425877 Enrollment ID: I20100812000801 |
| Provider Name | Carolyn O'connor |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1659310811 PECOS PAC ID: 7517995020 Enrollment ID: I20101104000948 |
| Provider Name | Leon Mccrea |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518118553 PECOS PAC ID: 3678767480 Enrollment ID: I20101104001399 |
| Provider Name | Mitzie L. Grant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063453439 PECOS PAC ID: 0143416974 Enrollment ID: I20101119000058 |
| Provider Name | Susanna Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770523870 PECOS PAC ID: 0749479756 Enrollment ID: I20110106000420 |
| Provider Name | Adrienne F Willard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942466396 PECOS PAC ID: 7719165612 Enrollment ID: I20110623000621 |
| Provider Name | Sunil Verma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184651606 PECOS PAC ID: 4385805860 Enrollment ID: I20120410000229 |
| Provider Name | Rhonda Albright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851734974 PECOS PAC ID: 7012158934 Enrollment ID: I20130718000444 |
| Provider Name | Kim Huong T Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134430267 PECOS PAC ID: 5597903302 Enrollment ID: I20130926000660 |
| Provider Name | Munish R. Bakshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508057365 PECOS PAC ID: 5890830426 Enrollment ID: I20141219000834 |
| Provider Name | Amanda Z De La Paz |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1215236484 PECOS PAC ID: 1254564362 Enrollment ID: I20150610001958 |
| Provider Name | Gina M Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588042105 PECOS PAC ID: 4981761046 Enrollment ID: I20150625001063 |
| Provider Name | Charles C Stanfa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861832156 PECOS PAC ID: 3072891258 Enrollment ID: I20161021001118 |
| Provider Name | Tara D Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013469162 PECOS PAC ID: 4082998786 Enrollment ID: I20170224000083 |
| Provider Name | Kelli Deiaco |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699945766 PECOS PAC ID: 3577833730 Enrollment ID: I20170720000829 |
| Provider Name | Alicia K Tucker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689703563 PECOS PAC ID: 3173717543 Enrollment ID: I20171019002153 |
| Provider Name | Janet Cruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487975454 PECOS PAC ID: 2062650799 Enrollment ID: I20171030000562 |
| Provider Name | Amy Huang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326358953 PECOS PAC ID: 8729348735 Enrollment ID: I20180213002377 |
| Provider Name | Emily Margaret Levy |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1598108607 PECOS PAC ID: 1153553334 Enrollment ID: I20180223000914 |
| Provider Name | Katelyn Rose Shaffer |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1699293928 PECOS PAC ID: 8729343678 Enrollment ID: I20180525000255 |
| Provider Name | Kristen M Ryczak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356603872 PECOS PAC ID: 0840590972 Enrollment ID: I20180730000661 |
| Provider Name | Angela Silverman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386030674 PECOS PAC ID: 9335460690 Enrollment ID: I20180906001679 |
| Provider Name | Maya A Bass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376988279 PECOS PAC ID: 8224261060 Enrollment ID: I20181004002216 |
| Provider Name | Kelly O'connell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861884546 PECOS PAC ID: 0941554745 Enrollment ID: I20181114001473 |
| Provider Name | Prasad R Joshi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881009686 PECOS PAC ID: 2860730777 Enrollment ID: I20190218002752 |
| Provider Name | Hilary Susskind |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780034165 PECOS PAC ID: 6800127564 Enrollment ID: I20191010000199 |
| Provider Name | Hanna M Ramsburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992211023 PECOS PAC ID: 7911268628 Enrollment ID: I20200211002562 |
| Provider Name | Jared Goldman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528477098 PECOS PAC ID: 5597183590 Enrollment ID: I20200908001507 |
| Provider Name | Catherine Mcelwain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215994157 PECOS PAC ID: 1355470311 Enrollment ID: I20210210000788 |
| Provider Name | David Tanier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457949463 PECOS PAC ID: 2961818281 Enrollment ID: I20210311002166 |
| Provider Name | Daniel Judes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891393963 PECOS PAC ID: 1557764271 Enrollment ID: I20210719002425 |
| Provider Name | Ronke Babalola |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487936712 PECOS PAC ID: 8022306273 Enrollment ID: I20210811000256 |
| Provider Name | Aaron R Palmquist |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1144714577 PECOS PAC ID: 8224423900 Enrollment ID: I20220315002892 |
| Provider Name | Kaitlin Elizabeth O'malley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922563089 PECOS PAC ID: 7113313628 Enrollment ID: I20220411000890 |
| Provider Name | April Barnum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265811814 PECOS PAC ID: 1052623311 Enrollment ID: I20220420000423 |
| Provider Name | Shemeica Binns |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740784446 PECOS PAC ID: 0244614923 Enrollment ID: I20220830000221 |
| Provider Name | Ukpere Nimtor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336626498 PECOS PAC ID: 4486065919 Enrollment ID: I20230607001865 |
Laura Yatvin Nutrition Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4231 N. 5th Street, Philadelphia, PA 19140 Phone: 215-455-5370 Fax: 215-455-5374 | |
Health Hero Pa Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 217 Dickinson St, Philadelphia, PA 19147 Phone: 484-667-3382 | |
Vo Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1735 Market St Fl 52, Philadelphia, PA 19103 Phone: 267-314-7252 | |
Rooted Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3101 Tyson Ave, Philadelphia, PA 19149 Phone: 917-861-2531 | |
Care Health Partners Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1308 Cottman Ave, Philadelphia, PA 19111 Phone: 732-766-1827 Fax: 609-890-0950 | |
University Of Penn - Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3400 Spruce St, 3 Ravdin, Suite F, Pulmonary & Critical Care, Philadelphia, PA 19104 Phone: 215-662-3202 | |