Individual provider Active NPI

Annina N. Wilkes, M.D.

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1043243223
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD038509E Issued in PA
Practice address
111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824
Phone
(215) 955-2900
Fax
(215) 923-1562
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD038509E PA Primary

Addresses

Primary practice location

111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824

Mailing address

111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824
Phone (215) 955-2900

Other identifiers 2

IdentifierTypeStateIssuer
6380107MedicaidNJ
001258024MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040311000842 PA Practitioner - Diagnostic Radiology 4183513872 Reassigns benefits to 5 organizations
I20200928002852 NJ Practitioner - Diagnostic Radiology 4183513872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Temple University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University Radiology Associates LLCGroup PAC ID 7315845708, shared by 3 NPIs, 110 clinicians
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians
Jefferson University Physicians of New Jersey PCGroup PAC ID 9931325131, 117 clinicians

Practice addresses (Care Compare)

1 W Germantown Pike
East Norriton, PA 19401-1513
Phone (610) 277-3202

10160 Bustleton Ave E
Jefferson Outpatient Imaging
Philadelphia, PA 19116-3749
Phone (215) 503-4900

111 S 11TH St
3Rd FLR Suite 3390
Philadelphia, PA 19107-5098
Phone (800) 858-1662

2211 Chapel Ave W
Suite 403
Cherry Hill, NJ 08002-2048
Phone (856) 922-5030

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 582-2500

443 Laurel Oak Rd
Voorhees, NJ 08043-4419

650 Carnegie Blvd
Suite 240
Malvern, PA 19355-8519
Phone (215) 503-4900

850 Walnut St
Philadelphia, PA 19107-5109

999 Route 73 N 101
Jefferson Outpatient Imaging
Marlton, NJ 08053-1227
Phone (856) 424-2929

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rittenhouse Imaging Center, LLC Diagnostic Radiology CurrentSince Jul 24, 2020 Accepting new patients
Jefferson University Physicians of New Jersey, P.C. CurrentSince Jun 24, 2020 Accepting new patients
Jeanes Radiology Associates LLC Diagnostic Radiology CurrentSince Feb 24, 2010 Accepting new patients
Jefferson University Radiology Associates LLC Diagnostic Radiology CurrentSince Apr 18, 2010 Accepting new patients
Jefferson University Physicians Diagnostic Radiology CurrentSince Nov 2, 1991 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Aug 26, 2020 Accepting new patients
Lebanon Diagnostic Imaging, LLC Diagnostic Radiology CurrentSince Jul 24, 2020 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Apr 18, 2010 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology Current Accepting new patients
Insight Health Corp PastSince Jul 24, 2020 Accepting new patients
Imaging Professionals of Pennsylvania PC Diagnostic Radiology Past Accepting new patients

Locations

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

999 Route 73 N
Ste 101
Marlton, NJ 08053
Phone (856) 424-2929

243 Hurffville Crosskeys Rd
Sewell, NJ 08080
Phone (609) 680-9263

443 Laurel Oak Rd
Ste 130
Voorhees, NJ 08043
Phone (856) 741-0122

462 Gateway Ave
Chambersburg, PA 17201
Phone (717) 263-4999

150 E Pennsylvania Ave
Downingtown, PA 19335
Phone (215) 772-9674

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

301 Callowhill St
Philadelphia, PA 19123
Phone (215) 574-9400

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

850 Walnut St
Philadelphia, PA 19107
Phone (215) 503-4900

111 S 11th St
Ste 3390
Philadelphia, PA 19107
Phone (215) 955-2900

111 S 11th St
Ste G3390
Philadelphia, PA 19107
Phone (215) 955-2900

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

111 S 11th St
Fl 3
William Penn Annex West, PA 19107
Phone (215) 955-4804

Organizations & group practices 11

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 3

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1043243223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-2900",
            "fax_number": "215-923-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-2900",
            "fax_number": "215-923-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKES",
        "first_name": "ANNINA",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD038509E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6380107",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001258024",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.