Individual provider Active NPI

Rachel Mojisola Dada, MD

  • Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1063739613
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD451263 Issued in PA
Practice address
3400 Spruce St
210 White
Philadelphia, PA 19104-4206
Phone
(215) 662-9664
NPI assigned
Apr 22, 2010
Last updated
Nov 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD451263 PA Primary

Addresses

Primary practice location

3400 Spruce St
210 White
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce St
210 White
Philadelphia, PA 19104-4206
Phone (215) 662-9664

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
I20140930002490 PA Practitioner - Anesthesiology 1355561028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Perelman School of Med at the University of Pennsylvania, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Anesthesia Services PCGroup PAC ID 3173437613, 437 clinicians

Practice addresses (Care Compare)

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (610) 526-3000

744 W Lancaster Ave
Wayne, PA 19082-2523
Phone (610) 645-2000

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1271894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1063739613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "210 WHITE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "210 WHITE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADA",
        "first_name": "RACHEL",
        "middle_name": "MOJISOLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-22",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD451263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.