Individual provider Active NPI

Elena Adamov, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1003961400
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD430639 Issued in PA
Practice address
1427 Vine St
6TH FL
Philadelphia, PA 19102-1031
Phone
(215) 762-6565
Fax
(215) 762-6997
NPI assigned
Jan 24, 2007
Last updated
Oct 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD430639 PA Primary

Addresses

Primary practice location

1427 Vine St
6TH FL
Philadelphia, PA 19102-1031

Mailing address

1601 Cherry St
Suite 11511
Philadelphia, PA 19102-1321
Phone (215) 255-7822

Other identifiers 1

IdentifierTypeStateIssuer
101865839MedicaidPA

Other names 1

  • Elena Klanaman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070220000256 PA Practitioner - Internal Medicine 7113029281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5501 Old York Rd
Phila, PA 19141-3018
Phone (215) 456-9850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD430639PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jul 1, 2020 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Einstein Practice Plan Inc Internal Medicine Past Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

5401 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-8220

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

Networks

  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • OH PPO

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1003961400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021321",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 VINE ST",
            "address_2": "6TH FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021031",
            "telephone_number": "215-762-6565",
            "fax_number": "215-762-6997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMOV",
        "first_name": "ELENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD430639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101865839",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELENA",
            "last_name": "KLANAMAN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.