Individual provider Active NPI

Andie Rebecca Belkoff

  • Student in an Organized Health Care Education/Training Program
  • Philadelphia, PA
National Provider Identifier
1114546314
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
833 Chestnut St Ste 210
Philadelphia, PA 19107-4405
Phone
(215) 955-8420
Fax
(215) 503-0429
NPI assigned
Apr 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

833 Chestnut St Ste 210
Philadelphia, PA 19107-4405

Mailing address

833 Chestnut St Ste 210
Philadelphia, PA 19107-4405
Phone (215) 955-5638

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
I20200501000343 PA Order and Referring Only - PsychiatryPractitioner - Psychiatry 1759711922

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4020 Aspen Grove Dr
Suite 900
Franklin, TN 37067-2952

523 Edgewood Dr
Lafayette Hill, PA 19444-2241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1114546314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 210",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074405",
            "telephone_number": "215-955-5638",
            "fax_number": "215-503-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 210",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074405",
            "telephone_number": "215-955-8420",
            "fax_number": "215-503-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELKOFF",
        "first_name": "ANDIE",
        "middle_name": "REBECCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.