Individual provider Active NPI

Bita Momenaei, MD

  • Student in an Organized Health Care Education/Training Program
  • Philadelphia, PA
National Provider Identifier
1013702927
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1020 Sansom St Ste 1651B
Philadelphia, PA 19107-5002
Phone
(215) 955-9837
Fax
(215) 955-9870
NPI assigned
Apr 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1020 Sansom St Ste 1651B
Philadelphia, PA 19107-5002

Mailing address

241 S 6TH St Apt 2203
Philadelphia, PA 19106-3735
Phone (805) 418-0214

Other practice location 1

833 Chestnut St Ste 301
Philadelphia, PA 19107-4414
Phone (215) 955-2363

Other practice location 2

833 Chestnut St Ste 220
Philadelphia, PA 19107-4405
Phone (215) 955-8465

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
I20250728001991 PA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8921515776

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1744329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1013702927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 S 6TH ST APT 2203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063735",
            "telephone_number": "805-418-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST STE 1651B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075002",
            "telephone_number": "215-955-9837",
            "fax_number": "215-955-9870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 Chestnut St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074414",
            "country_code": "US",
            "telephone_number": "215-955-2363",
            "fax_number": "215-955-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "833 Chestnut St Ste 220",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074405",
            "country_code": "US",
            "telephone_number": "215-955-8465",
            "fax_number": "215-955-2516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOMENAEI",
        "first_name": "BITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-11",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.