NPIMap

Drexel University

Organization Active NPI Infectious Disease Physician · Philadelphia, PA

NPI 1154590933 · NPPES record last updated Jun 9, 2022

Key facts

NPI
1154590933
Entity type
Organization (NPI type 2)
Primary specialty
Infectious Disease Physician 207RI0200X
Legal business name
DREXEL UNIVERSITY
Practice address
1427 Vine St
2ND Floor
Philadelphia, PA 19102-1031
Phone
(215) 762-2530
Fax
(215) 762-2531
NPI assigned
Feb 26, 2008
Organization subpart
No

Authorized official

Name
Edward E Waldov
Title
Director of Revenue Cycle - Finance
Phone
(215) 255-7751

Other NPIs on the same Medicare enrollment 45

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 45

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140729001682 PA Part B Supplier - Clinic/Group Practice 5496664740 Receives reassigned benefits from 340 practitioners
45 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA; Warminster, PA; Elkins Park, PA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207RI0200X Yes

Addresses

Primary practice location

1427 Vine St
2ND Floor
Philadelphia, PA 19102-1031

Mailing address

1601 Cherry St
Suite 11511
Philadelphia, PA 19102-1321
Phone (215) 255-7751

Other names

  • Drexel ID Partnership Clinic SPEC Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 9, 2022.

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1154590933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021321",
            "telephone_number": "215-255-7751",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 VINE ST",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021031",
            "telephone_number": "215-762-2530",
            "fax_number": "215-762-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREXEL UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "WALDOV",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE - FINANCE",
        "authorized_official_telephone_number": "215-255-7751"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drexel ID Partnership Clinic SPEC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Drexel ID Partnership Clinic SPEC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Infectious Disease Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.