Individual provider Active NPI

Fabian A Vengoechea, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1033150800
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD427681 Issued in PA
Practice address
7600 Central Ave
Philadelphia, PA 19111-2442
Phone
(215) 728-2000
Fax
(215) 214-4119
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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 MD427681 PA Primary

Addresses

Primary practice location

7600 Central Ave
Philadelphia, PA 19111-2442

Mailing address

257 W Cayuga St
Philadelphia, PA 19140-2439
Phone (267) 368-6953

Other identifiers 3

IdentifierTypeStateIssuer
CD4829OtherPARAIL ROAD MEDICARE GROUP TPI
1007278000OtherPAMEDICAID TPI GROUP
597586OtherPAMEDICARE GROUP TPI

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
I20060509000564 PA Practitioner - Internal Medicine 2668483330 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Cayuga Medicine PCGroup PAC ID 8022398080, 2 clinicians

Practice addresses (Care Compare)

257 W Cayuga St
Philadelphia, PA 19140-2439
Phone (267) 368-6953

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physician Inc. Internal Medicine CurrentSince Oct 15, 2011 Accepting new patients
West Cayuga Medicine PC Internal Medicine CurrentSince Oct 5, 2016 Accepting new patients
Temple Physicians Inc. CurrentSince Oct 15, 2011 Accepting new patients
Temple Physicians Inc Internal Medicine Current Accepting new patients
Temple Physicians Inc Past Accepting new patients
Temple Physicians Inc Internal Medicine Past Accepting new patients
Temple Physicians Inc Internal Medicine Past Accepting new patients
Temple Physicians Inc Past Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

32 S Pennell Rd
Media, PA 19063

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

257 W Cayuga St
Philadelphia, PA 19140
Phone (267) 368-6953

1001 Baltimore Pike
Ste 9B
Springfield, PA 19064
Phone (267) 368-6953

Organizations & group practices 8

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1033150800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 W CAYUGA ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402439",
            "telephone_number": "267-368-6953",
            "fax_number": "215-621-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 CENTRAL AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112442",
            "telephone_number": "215-728-2000",
            "fax_number": "215-214-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENGOECHEA",
        "first_name": "FABIAN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD427681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE GROUP TPI",
            "identifier": "CD4829",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID TPI GROUP",
            "identifier": "1007278000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP TPI",
            "identifier": "597586",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.