Individual provider Active NPI

Edward Raymond Oliver, MD, PHD

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1053460964
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD440339 Issued in PA
Practice address
3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Radiology
Philadelphia, PA 19104-4319
Phone
(215) 590-7000
Fax
(215) 590-9348
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 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 MD440339 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Radiology
Philadelphia, PA 19104-4319

Mailing address

100 E Penn SQ
9TH FL
Philadelphia, PA 19107-3323
Phone (267) 425-9232

Other identifiers 1

IdentifierTypeStateIssuer
940577OtherVAAETNA

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
I20110720000053 PA Practitioner - Diagnostic Radiology 8628246592 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Michigan Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Children'S Hospital, IncGroup PAC ID 0345154399, 40 clinicians

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (267) 425-9505

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Jul 1, 2019 Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Aug 1, 2018 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 1, 2019 Accepting new patients
Geisinger Clinic Current Accepting new patients
University of Penn-Medical Group Diagnostic Radiology CurrentSince Aug 17, 2015 Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Aug 1, 2018 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Fpa Hospital Based Current Accepting new patients
University of Penn-Medical Group CurrentSince Aug 17, 2015 Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
Fairfax Radiological Consultants Diagnostic Radiology Past Accepting new patients

Locations

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

100 N Academy Ave
Danville, PA 17822

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

250 King of Prussia Rd
Ste 3
Radnor, PA 19087
Phone (610) 902-1800

420 W Linfield Trappe Rd
Royersford, PA 19468
Phone (610) 279-8686

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1053460964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9232",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA - RADIOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-7000",
            "fax_number": "215-590-9348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "EDWARD",
        "middle_name": "RAYMOND",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD440339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "940577",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.