Individual provider Active NPI

Soumini Chintala

  • Neonatal-Perinatal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1063823078
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
MD484536 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-6606
NPI assigned
May 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 55823 AZ
Neonatal-Perinatal Medicine Physician 2080N0001X MD484536 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3500 N Broad St RM 1a
Philadelphia, PA 19140-4106
Phone (215) 707-2433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, PA2 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
I20211222001019 AZ Practitioner - Anesthesiology 7618255472 Reassigns benefits to 1 organization
I20241126004484 PA Practitioner - Pediatric Medicine 7618255472 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55823AZMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
STC Pediatrics LLC Pediatrics CurrentSince Jan 1, 2024 Accepting new patients
Phoenix Children'S Hospital Pediatrics CurrentSince Sep 16, 2021 Accepting new patients
STC Pediatrics LLC Pediatrics Current Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Jan 1, 2024 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Sep 16, 2021 Accepting new patients
Temple University Hospital, Inc Past Accepting new patients
Temple University Hospital, Inc Past Accepting new patients
St. Luke'S Hospital Past Accepting new patients

Locations

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

Interoperability endpoints

  • Direct secure messaging: schintala192358@direct.valleywisehealth.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1063823078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD ST RM 1A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106",
            "telephone_number": "215-707-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINTALA",
        "first_name": "SOUMINI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AZ",
            "license": "55823",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "PA",
            "license": "MD484536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.