NPIMap

Individual provider Active NPI

Vimmi Viresh Panchal, MD

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1154764355
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD461361 Issued in PA
Practice address
51 N 39TH St
Philadelphia, PA 19104-2640
Phone
(215) 662-2749
Fax
(215) 243-4624
NPI assigned
Apr 8, 2013
Last updated
Sep 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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 MD461361 PA Primary

Addresses

Primary practice location

51 N 39TH St
Philadelphia, PA 19104-2640

Mailing address

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-2749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170726000438 PA Practitioner - Geriatric MedicinePractitioner - Family Practice 1456594845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
Other, 2013
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)

145 King of Prussia Rd
Suite 205
Radnor, PA 19087-4557
Phone (610) 902-4859

250 King of Prussia Rd
Radnor, PA 19087-5227
Phone (610) 902-5600

3701 Market St
FL 6
Philadelphia, PA 19104-5508
Phone (215) 662-2746

3819 Chestnut St
Philadelphia, PA 19104-3171
Phone (215) 662-2746

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Family Medicine CurrentSince Jul 1, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2017 Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Presbyterian Medical Center of the University of Pennsylvania Health S Past Accepting new patients
Saint Ignatius Nursing Home Past Accepting new patients
Renaissance Healthcare & Rehabilitation Center LLC Past Accepting new patients
4401 Haverford Avenue Opco LLC Past Accepting new patients

Locations

3615 Chestnut St
Philadelphia, PA 19104
Phone (215) 662-2746

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
West Park Rehabilitation and Nursing CenterPhiladelphia, PA, CCN 395686 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2024
Aug 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1154764355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-2749",
            "fax_number": "215-243-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-2749",
            "fax_number": "215-243-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCHAL",
        "first_name": "VIMMI",
        "middle_name": "VIRESH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-08",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD461361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.