Active NPI
Sidra Ghafoor, M.D.
- Psychiatry Physician
- Philadelphia, PA
National Provider Identifier
1154765592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD463038
- Practice address
- 3900 Woodland Ave
Philadelphia, PA 19104-4551 - Phone
- (215) 823-5800
- NPI assigned
- Apr 27, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD463038 | PA | Primary |
Addresses
Primary practice location
3900 Woodland Ave
Philadelphia, PA 19104-4551
Mailing address
3400 Spruce St
Philadelphia, PA 19104-4238
Other practice location 1
4755 Ogletown Stanton Rd
Department of Internal Medicine
Newark, DE 19718-2200
Phone (302) 733-6338
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 5, 2020 through Oct 5, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD463038 | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587859200000",
"number": "1154765592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 WOODLAND AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044551",
"telephone_number": "215-823-5800"
}
],
"practiceLocations": [
{
"address_1": "4755 Ogletown Stanton Rd",
"address_2": "Department of Internal Medicine",
"address_purpose": "LOCATION",
"city": "Newark",
"state": "DE",
"postal_code": "197182200",
"country_code": "US",
"telephone_number": "302-733-6338",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GHAFOOR",
"first_name": "SIDRA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-27",
"last_updated": "2020-04-26",
"certification_date": "2020-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD463038",
"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 Apr 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.