Individual provider Active NPI

Ryan Nachwalter, MD

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1073252847
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MT226760 Issued in PA
Practice address
1015 Walnut St Ste 620
Philadelphia, PA 19107-5005
Phone
(215) 955-6864
NPI assigned
May 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT226760 PA Primary

Addresses

Primary practice location

1015 Walnut St Ste 620
Philadelphia, PA 19107-5005

Mailing address

200 W Washington SQ Apt 3601
Philadelphia, PA 19106-3569
Phone (973) 713-0987

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
I20220607000627 PA Order and Referring Only - General SurgeryPractitioner - General Surgery 0648658492

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1073252847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W WASHINGTON SQ APT 3601",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063569",
            "telephone_number": "973-713-0987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 WALNUT ST STE 620",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075005",
            "telephone_number": "215-955-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACHWALTER",
        "first_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT226760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.