NPIMap

Individual provider Active NPI

Alexander J Brucker, MD

  • Retina Specialist (Ophthalmology) Physician
  • Philadelphia, PA
National Provider Identifier
1073624706
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
MD020304E Issued in PA
Practice address
3801 Filbert St
Philadelphia, PA 19104-2640
Phone
(215) 662-8100
NPI assigned
Aug 31, 2006
Last updated
Apr 11, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD020304E PA
Retina Specialist (Ophthalmology) Physician 207WX0107X MD020304E PA Primary

Addresses

Primary practice location

3801 Filbert St
Philadelphia, PA 19104-2640

Mailing address

3801 Filbert St
Philadelphia, PA 19104-2640
Phone (215) 662-8100

Other identifiers 1

IdentifierTypeStateIssuer
000650140MedicaidPA

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
I20100316000483 PA Practitioner - Ophthalmology 9830224815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Perelman School of Med at the University of Pennsylvania, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-8100

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

State licenses

LicenseStateTypeSpecialty
MD020304EPAMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group Ophthalmology CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Bih Radiologic Foundation Inc Past Accepting new patients

Locations

3400 Civic Center Blvd
#3W
Philadelphia, PA 19104
Phone (215) 662-2891

3615 Chestnut St
Ste 141
Philadelphia, PA 19104
Phone (215) 662-2600

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

145 King of Prussia Rd
Ste 204
Radnor, PA 19087
Phone (610) 902-2020

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1073624706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 FILBERT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 FILBERT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKER",
        "first_name": "ALEXANDER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD020304E",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "PA",
            "license": "MD020304E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000650140",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.