Individual provider Active NPI

Androniki Bili, M.D.

  • Rheumatology Physician
  • Philadelphia, PA
National Provider Identifier
1104802719
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD429648 Issued in PA
Practice address
3400 Spruce St
5 White
Philadelphia, PA 19104-4238
Phone
(215) 662-2454
Fax
(215) 662-7527
NPI assigned
Dec 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X MD429648 PA Primary

Addresses

Primary practice location

3400 Spruce St
5 White
Philadelphia, PA 19104-4238

Mailing address

3400 Spruce St
5 White
Philadelphia, PA 19104-4238
Phone (215) 662-2454

Other identifiers 2

IdentifierTypeStateIssuer
101697733MedicaidPA
005875820MedicaidVA

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
I20060922000050 PA Practitioner - RheumatologyPractitioner - Internal Medicine 1850311143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
FL 1
Philadelphia, PA 19104-5161
Phone (215) 662-2454

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD429648PAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Sep 1, 2006 Accepting new patients
University of Penn-Medical Group Rheumatology CurrentSince Jul 1, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2017 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Geisinger Clinic CurrentSince Sep 1, 2006 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

3400 Civic Center Blvd
Fl 1
Philadelphia, PA 19104
Phone (215) 615-5864

3400 Spruce St
Fl 5
Philadelphia, PA 19104
Phone (215) 662-2777

Organizations & group practices 7

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 2

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": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1104802719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "5 WHITE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-2454",
            "fax_number": "215-662-7527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "5 WHITE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-2454",
            "fax_number": "215-662-7527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILI",
        "first_name": "ANDRONIKI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "MD429648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101697733",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005875820",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.