Jefferson Medical Care, PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

JEFFERSON MEDICAL CARE, PC

Practice address

211 S 9TH St
Suite 305
Philadelphia, PA 19107-6810

Phone

(215) 955-9558

Fax

(215) 955-3920

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Hristos Ristas

Title

Vice President

Phone

(215) 955-9298

Specialties & licenses 8

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 28

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

• Kenneth A. Andreoni, M.D.

  • Transplant Surgery Physician
  • Philadelphia, PA
  • NPI 1780778035
  Medicare reassignment NPD
• Birgit Rakel, M.D.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1578584835
  Medicare reassignment NPD
• Pooja Singh, MD

  • Nephrology Physician
  • Philadelphia, PA
  • NPI 1871787739
  Medicare reassignment NPD
• Manushi Patel

  • Orofacial Pain Dentistry
  • Philadelphia, PA
  • NPI 1992542401
  NPD
• Thomas C Barone, DO

  • Pain Medicine Physician
  • Philadelphia, PA
  • NPI 1780898965
  NPD (past)
• Madeleine A Becker, M.D.

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1669539581
  NPD (past)
• Justin Burns, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Philadelphia, PA
  • NPI 1578778262
  NPD (past)
• Ira Scott Cantor, M.D

  • Internal Medicine Physician
  • Phoenixville, PA
  • NPI 1760425755
  NPD (past)
• Sung H Cho, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Philadelphia, PA
  • NPI 1952400780
  NPD (past)
• William Joseph Demedio, M.D.

  • Family Medicine Physician
  • Springfield, PA
  • NPI 1659313419

  Emergency Medicine

  NPD (past)
• Kristin L. Desimone, M.D.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1477586501
  NPD (past)
• Victor A. Diaz Jr., M.D.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1013933548
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1164511747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 828937",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191828937",
            "telephone_number": "215-955-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S 9TH ST",
            "address_2": "SUITE 305",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076810",
            "telephone_number": "215-955-9558",
            "fax_number": "215-955-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON MEDICAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "RISTAS",
        "authorized_official_first_name": "HRISTOS",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "215-955-9298",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016886700001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jefferson Headache Center
• Jefferson Headache Center
• Jefferson Health - Northeast
• Jefferson Health - Northeast
• Jefferson Hospital
• Jefferson University Hospital
• Jefferson University Hospital
• Jefferson University Physcians
• Jefferson University Physcians
• Jefferson University Physcians

• Nephrology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nephrology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.