NPIMap

Individual provider Active NPI

Andrew D Siderowf, MD

  • Neurology Physician
  • Philadelphia, PA
National Provider Identifier
1053343285
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD054220L Issued in PA
Practice address
3400 Spruce Street
2 Ravdin Building
Philadelphia, PA 19104
Phone
(215) 662-3606
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD054220L PA Primary

Addresses

Primary practice location

3400 Spruce Street
2 Ravdin Building
Philadelphia, PA 19104

Mailing address

3400 Spruce St
2 Ravdin Building
Philadelphia, PA 19104-4206

Other identifiers 1

IdentifierTypeStateIssuer
0016926270001MedicaidPA

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
I20050525000942 PA Practitioner - Neurology 5597707968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Duke University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-3606

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince May 1, 2017 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2017 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

801 Spruce St
Fl 3
Philadelphia, PA 19107
Phone (215) 627-5272

3737 Market St
Fl 8
Philadelphia, PA 19104
Phone (215) 662-4333

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

1800 Lombard St
Fl 1
Philadelphia, PA 19146
Phone (215) 893-2600

145 King of Prussia Rd
Wayne, PA 19087
Phone (610) 687-8239

330 S 9th St
William Penn Annex West, PA 19107
Phone (215) 829-6500

Organizations & group practices 4

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 7

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1053343285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "2 RAVDIN BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "2 RAVDIN BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDEROWF",
        "first_name": "ANDREW",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD054220L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016926270001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.