NPIMap

Individual provider Active NPI

Erik Brandsma, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1013243112
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
MD454625 Issued in PA
Practice address
3401 Civic Center Blvd
Children's Hospital of Philadelphia
Philadelphia, PA 19104-4319
Phone
(215) 590-1000
Fax
(267) 425-9299
NPI assigned
Oct 23, 2009
Last updated
Jul 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X MD454625 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Children's Hospital of Philadelphia
Philadelphia, PA 19104-4319

Mailing address

100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9200

Other identifiers 1

IdentifierTypeStateIssuer
1030357550001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120319000032 NJ Practitioner - Pediatric Medicine 0244414811 Reassigns benefits to 2 organizations
I20151008000654 PA Practitioner - Pediatric Medicine 0244414811 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
Cooper Pediatric Specialists, PC CurrentSince Feb 1, 2012 Accepting new patients
Childrens Health Care Associates, Inc Neonatal-Perinatal Medicine CurrentSince Aug 24, 2015 Accepting new patients
Childrens Health Care Associates of New Jersey PC Current Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Sep 4, 2017 Accepting new patients
University of Penn-Medical Group Neonatal-Perinatal Medicine CurrentSince Jul 4, 2015 Accepting new patients
Childrens Health Care Associates, Inc Current Accepting new patients
Childen's Health Care Associates Inc. CurrentSince Aug 24, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 4, 2015 Accepting new patients
Children's Healthcare Associates of New Jersey PC CurrentSince Sep 4, 2017 Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

3 Cooper Plz
Rm 200
Camden, NJ 08103
Phone (609) 342-2001

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3400 Spruce St
Fl 8
Philadelphia, PA 19104
Phone (215) 662-2415

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1013243112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9200",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1000",
            "fax_number": "267-425-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDSMA",
        "first_name": "ERIK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-23",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "PA",
            "license": "MD454625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030357550001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.