NPIMap

Individual provider Active NPI

Kristopher D. Ahn, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1073967451
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD470105 Issued in PA
Practice address
861 E Allegheny Ave Ste MSB 1134
Philadelphia, PA 19134-2401
Phone
(215) 302-3600
Fax
(215) 329-2369
NPI assigned
Apr 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD470105 PA
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD470105 PA Primary

Addresses

Primary practice location

861 E Allegheny Ave Ste MSB 1134
Philadelphia, PA 19134-2401

Mailing address

4417 N 6TH St
Philadelphia, PA 19140-2319
Phone (215) 302-3600

Other practice location 1

4417 N 6th St
Philadelphia, PA 19140-2319
Phone (215) 302-3600

Other practice location 2

2940 N 5th St
Philadelphia, PA 19133-2801
Phone (215) 302-3600

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
I20200714000103 PA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 2365865094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
State University of Ny Upstate Medical University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Esperanza Health Center, Inc.Group PAC ID 6103815071, 32 clinicians

Practice addresses (Care Compare)

861 E Allegheny Ave
Philadelphia, PA 19134-2401
Phone (215) 302-3600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Esperanza Health Center, Inc. CurrentSince Aug 8, 2020 Accepting new patients
Esperanza Health Center, Inc. Past Accepting new patients
Temple University Hospital, Inc Past Accepting new patients

Locations

4417 N 6th St
Philadelphia, PA 19140
Phone (215) 302-3150

861 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 302-3600

2940 N 5th St
Philadelphia, PA 19133
Phone (215) 221-6633

861 E Allegheny Ave
Ste Msb
Philadelphia, PA 19134
Phone (215) 302-3600

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1073967451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 N 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402319",
            "telephone_number": "215-302-3600",
            "fax_number": "215-329-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 E ALLEGHENY AVE STE MSB 1134",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191342401",
            "telephone_number": "215-302-3600",
            "fax_number": "215-329-2369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4417 N 6th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191402319",
            "country_code": "US",
            "telephone_number": "215-302-3600",
            "fax_number": "215-329-2369",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2940 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191332801",
            "country_code": "US",
            "telephone_number": "215-302-3600",
            "fax_number": "215-329-2369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHN",
        "first_name": "KRISTOPHER",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-21",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD470105",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD470105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.