Ramon Omar Vicencio, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

MD484891 Issued in PA

Practice address

10 Shurs LN
Philadelphia, PA 19127-2123

Phone

(215) 482-1234

Fax

(215) 482-0465

NPI assigned

Mar 31, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Temple Health - Chestnut Hill Hospital Hospital, Philadelphia, PA, CCN 390026

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Temple Faculty Practice Plan Inc

  dba Temple Faculty Anesthesiology Associates

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1881176949
  Medicare reassignment Care Compare group NPD
• Temple Faculty Practice Plan, Inc

  dba Temple Faculty Pathology Associates

  • Anatomic Pathology Physician
  • Philadelphia, PA
  • NPI 1972086650
  NPD
• Temple Faculty Practice Plan Inc

  dba Temple Faculty Multi-Specialty at NJ

  • Urology Physician
  • Voorhees, NJ
  • NPI 1407638794
  NPD
• CHH Community Health

  dba Chestnut Hill Hospital - Temple Health

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1437865953
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CHH Community Health

  dba Chestnut Hill Hospital - Temple Health

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1437865953
  Care Compare affiliation

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1083292130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST # A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105",
            "telephone_number": "215-707-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SHURS LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191272123",
            "telephone_number": "215-482-1234",
            "fax_number": "215-482-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICENCIO",
        "first_name": "RAMON",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "MD484891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ramonvicencio@sffp.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "St. Francis Hospital direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "701 N Clayton St",
            "city": "Wilmington",
            "state": "DE",
            "country_code": "US",
            "postal_code": "198053165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa Vettraino, D.D.S.
• Angela Nicole Viaene, PH.D.
• Matthew Dallas Vibbert, MD
• Vibrant Rehabilitation LLC
• Kimberly Vicari, MS/ATC
• Laura Nicoll Vicioso
• Carey Vickers, L.AC.
• Conor Moran Vickers, MD
• Rosemary Vickers, D.O.
• Jasmine Vickery, MD

• Sports Medicine (Family Medicine) Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Sports Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.