NPIMap

Organization Active NPI

Metropolitan Nephrology Associates, PC

Doing business as Metro Vascular Center

  • Ambulatory Surgical Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1043758790
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
METROPOLITAN NEPHROLOGY ASSOCIATES, PC
Doing business as
Metro Vascular Center
Practice address
235 N Broad St
Suite 100
Philadelphia, PA 19107
Phone
(215) 568-6822
Fax
(215) 568-6833
NPI assigned
Feb 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Authorized official

Name
Ms. Jennifer Maximenko, MHA, RT
Title
Facility Administrator
Phone
(215) 568-6822

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X 22371501 PA
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 22371501 PA
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X 22371501 PA
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X 22371501 PA
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

235 N Broad St
Suite 100
Philadelphia, PA 19107

Mailing address

235 N Broad St
Suite 100
Philadelphia, PA 19107-1511
Phone (215) 568-6822

Other names 1

  • Metro Vascular Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532476800000",
    "number": "1043758790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 N BROAD ST",
            "address_2": "SUITE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071511",
            "telephone_number": "215-568-6822",
            "fax_number": "215-568-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N BROAD ST",
            "address_2": "SUITE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-568-6822",
            "fax_number": "215-568-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN NEPHROLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2018-07-25",
        "status": "A",
        "authorized_official_last_name": "MAXIMENKO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "215-568-6822",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MHA, RT"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "22371501",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "22371501",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "22371501",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "22371501",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Vascular Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.