Individual provider Active NPI

Farhan Zakri, M.D.

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1073965687
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA10560700 Issued in NJ
Practice address
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone
(267) 425-1740
NPI assigned
Jul 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA10560700 NJ Primary
Pediatrics Physician 208000000X MD467904 PA

Addresses

Primary practice location

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Mailing address

12 Roberta Way
Medford, NJ 08055-9622
Phone (718) 213-9761

Other practice location 1

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-3244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20200211002680 NJ Practitioner - Pediatric Medicine 1759629793 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD467904PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates of New Jersey PC Pediatrics Current Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Dec 18, 2019 Accepting new patients
Children's Healthcare Associates of New Jersey PC CurrentSince Dec 18, 2019 Accepting new patients
Virtua - Memorial Hospital Burlington County, Inc. Past Accepting new patients
Virtua - West Jersey Health System, Inc. Past Accepting new patients

Locations

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

1012 Laurel Oak Rd
Voorhees, NJ 08043
Phone (856) 435-0086

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

Organizations & group practices 5

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": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1073965687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ROBERTA WAY",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559622",
            "telephone_number": "718-213-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "267-425-1740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Bowman Dr",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439612",
            "country_code": "US",
            "telephone_number": "856-247-3244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAKRI",
        "first_name": "FARHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-07",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA10560700",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD467904",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.