Individual provider Active NPI

Paul Vanderbeek, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1164482766
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD058713L Issued in PA
Practice address
5501 Old York Rd
Philadelphia, PA 19141-3091
Phone
(215) 456-6679
Fax
(215) 456-8502
NPI assigned
Mar 27, 2006
Last updated
Nov 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD058713L PA Primary

Addresses

Primary practice location

5501 Old York Rd
Philadelphia, PA 19141-3091

Mailing address

101 E Olney Ave
Suite 400
Philadelphia, PA 19120-2421
Phone (215) 456-7000

Other identifiers 1

IdentifierTypeStateIssuer
001805604MedicaidPA

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
I20120120000514 PA Practitioner - Emergency Medicine 1658548359 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MHP MD PLLCGroup PAC ID 6507258423, 45 clinicians

Practice addresses (Care Compare)

48 A E Ridge Pike
Conshohocken, PA 19428-2117
Phone (484) 243-6735

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan, Inc CurrentSince Dec 5, 1998 Accepting new patients
Einstein Practice Plan Inc CurrentSince Dec 5, 1998 Accepting new patients
MHP MD PLLC CurrentSince May 1, 2022 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients

Locations

400 Fayette St
Ste 180
Conshohocken, PA 19428
Phone (484) 243-6622

48 E Ridge Pike
#A
Conshohocken, PA 19428
Phone (484) 243-6730

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

180 W Girard Ave
Ste 108
Philadelphia, PA 19123
Phone (267) 319-8047

5501 Old York Rd
#4W
Philadelphia, PA 19141

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

5501 York Rd
Ste 202
Philadelphia, PA 19141
Phone (215) 254-2630

5708 Ridge Ave
Philadelphia, PA 19128
Phone (267) 440-7779

Organizations & group practices 4

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1164482766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE",
            "address_2": "SUITE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202421",
            "telephone_number": "215-456-7000",
            "fax_number": "215-254-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413091",
            "telephone_number": "215-456-6679",
            "fax_number": "215-456-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBEEK",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD058713L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001805604",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.