Individual provider Active NPI

John H Chidester, MD

  • Specialist
  • Malvern, PA
National Provider Identifier
1124013586
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD-019797-E Issued in PA
Practice address
254 W. Lancaster Ave
Suite 2
Malvern, PA 19355-3087
Phone
(610) 644-5040
Fax
(610) 640-9170
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD-019797-E PA Primary

Addresses

Primary practice location

254 W. Lancaster Ave
Suite 2
Malvern, PA 19355-3087

Mailing address

254 W. Lancaster Ave
Suite 2
Malvern, PA 19355-3087
Phone (610) 644-5040

Other identifiers 4

IdentifierTypeStateIssuer
3646OtherPAAETNA PROVIDER NUMBER
055590OtherPAPERSONAL CHOICE PROVIDER
02598600OtherPAIDENPENDENCE BLUE CROSS
1754466OtherPAHIGHMARK GROUP ID #

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
I20111114000639 PA Practitioner - Orthopedic Surgery 4284808049 Reassigns benefits to 1 organization
Practice locations: Malvern, PA; Paoli, PA

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.32 of 100Reported as group
Quality
79.04
Promoting interoperability
99
Improvement activities
40
Cost
82.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-019797-EPAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Mar 27, 2021 Accepting new patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Mar 27, 2021 Accepting new patients

Locations

650 Carnegie Blvd
Ste 220A
Malvern, PA 19355
Phone (610) 707-4028

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1124013586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 W. LANCASTER AVE",
            "address_2": "SUITE 2",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193553087",
            "telephone_number": "610-644-5040",
            "fax_number": "610-640-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 W. LANCASTER AVE",
            "address_2": "SUITE 2",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193553087",
            "telephone_number": "610-644-5040",
            "fax_number": "610-640-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIDESTER",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD-019797-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "3646",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE PROVIDER",
            "identifier": "055590",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDENPENDENCE BLUE CROSS",
            "identifier": "02598600",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK GROUP ID #",
            "identifier": "1754466",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, PA

Sources for this page

Verify at the official NPI Registry.