Individual provider Active NPI

Delia Christina Meltontate, MD

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1114907334
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD043306L Issued in PA
Practice address
1415 North Broad Street, Suite 224
Broad Street Health Center
Philadelphia, PA 19122-3323
Phone
(215) 235-7944
Fax
(215) 235-3361
NPI assigned
Jan 23, 2006
Last updated
Jan 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD043306L PA Primary

Addresses

Primary practice location

1415 North Broad Street, Suite 224
Broad Street Health Center
Philadelphia, PA 19122-3323

Mailing address

5619-25 Vine Street
Spectrum Health Services, Inc.
Philadelphia, PA 19139-1302
Phone (215) 471-2761

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD043306LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physicians Inc. Family Medicine CurrentSince Dec 1, 2014 Accepting new patients
Temple Physician Inc. CurrentSince Dec 1, 2014 Accepting new patients
Washington Physician Services Family Medicine CurrentSince Aug 2, 2021 Accepting new patients
Temple Physicians Inc Family Medicine Current Accepting new patients
Erie Healthcare Services Inc Family Medicine Past Accepting new patients
Spectrum Health Services Inc Past Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

190 N Main St
Ste 204
Washington, PA 15301
Phone (724) 223-9335

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1114907334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5619-25 VINE STREET",
            "address_2": "SPECTRUM HEALTH SERVICES, INC.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191391302",
            "telephone_number": "215-471-2761",
            "fax_number": "215-471-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 NORTH BROAD STREET, SUITE 224",
            "address_2": "BROAD STREET HEALTH CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191223323",
            "telephone_number": "215-235-7944",
            "fax_number": "215-235-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTONTATE",
        "first_name": "DELIA",
        "middle_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD043306L",
            "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 Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.