Active NPI
Meguru Watanabe, M.D.
- Chronic Disease Hospital
- Philadelphia, PA
National Provider Identifier
1083821805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chronic Disease Hospital
- License
- MD428266
- Practice address
- 111 S 11TH St
Philadelphia, PA 19107-4824 - Phone
- (215) 955-6440
- NPI assigned
- May 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chronic Disease Hospital | 281P00000X | MD428266 | PA | Primary |
Addresses
Primary practice location
111 S 11TH St
Philadelphia, PA 19107-4824
Mailing address
275 S Bryn Mawr Ave
E52
Bryn Mawr, PA 19010-4202
Phone (610) 955-5111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD428266 | PA | MD | Chronic Disease Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083821805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 S BRYN MAWR AVE",
"address_2": "E52",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190104202",
"telephone_number": "610-955-5111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S 11TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074824",
"telephone_number": "215-955-6440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATANABE",
"first_name": "MEGURU",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "281P00000X",
"taxonomy_group": "",
"desc": "Chronic Disease Hospital",
"state": "PA",
"license": "MD428266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.