NPIMap

Individual provider Active NPI

Chaim Tuckman, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1023464641
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD467360 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-3397
NPI assigned
May 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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 MD467360 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

PO Box 824940
Philadelphia, PA 19182-4940
Phone (800) 634-7018

Other names 1

  • Chaim Rafa Tuckman-Vernon Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190911003103 PA Practitioner - Internal Medicine 4486983764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3326

Hospital & facility affiliations

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Jul 7, 2019 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Jul 7, 2019 Accepting new patients
Temple University Hospital, Inc Past Accepting new patients
Temple Faculty Practice Plan, Inc PastSince Jan 31, 2021 Accepting new patients

Locations

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

100 E Lehigh Ave
Philadelphia, PA 19125
Phone (215) 707-1200

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1023464641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 824940",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191824940",
            "telephone_number": "800-634-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKMAN",
        "first_name": "CHAIM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-12",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD467360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHAIM",
            "last_name": "TUCKMAN-VERNON",
            "middle_name": "RAFA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.