Individual provider Active NPI

Erkanda Plaku Ikonomi, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1083055628
Registry record updated Aug 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD455032 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-4545
NPI assigned
Jul 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD455032 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-4545

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
I20150908002591 PA Practitioner - GastroenterologyPractitioner - Internal Medicine 1658687595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Temple University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Methodist Associates in Healthcare, IncGroup PAC ID 6406755651, 387 clinicians

Practice addresses (Care Compare)

1095 Rydal Rd
Suite 100
Rydal, PA 19046-1711
Phone (267) 620-1100

Hospital & facility affiliations

  • Jefferson Abington Hospital Hospital, Abington, PA, CCN 390231
  • Holy Redeemer Hospital and Medical Center Hospital, Meadowbrook, PA, CCN 390097
  • Jefferson Lansdale Hospital Hospital, Lansdale, PA, CCN 390012
  • Doylestown Hospital Hospital, Doylestown, PA, CCN 390203

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy139
Upper gastrointestinal (GI) endoscopy for acid reflux107

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Aug 1, 2019 Accepting new patients
Methodist Associates in Healthcare, Inc Internal Medicine Current Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Aug 1, 2019 Accepting new patients
Jefferson University Physicians Past Accepting new patients
Gastrointestinal Associates, Inc Past Accepting new patients

Locations

1600 Horizon Dr
Ste 105
Chalfont, PA 18914
Phone (215) 368-6009

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

111 S 11th St
Ste 8490
Philadelphia, PA 19107
Phone (215) 955-6161

1095 Rydal Rd
Ste 100
Rydal, PA 19046
Phone (267) 620-1100

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.

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": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440115200000",
    "number": "1083055628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-4545"
        },
        {
            "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": "215-707-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKONOMI",
        "first_name": "ERKANDA",
        "middle_name": "PLAKU",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2015-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD455032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.