NPIMap

Individual provider Active NPI

Jeffrey D Bedrick, M.D.

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1174573869
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD048252L Issued in PA
Practice address
255 S 17TH St
Suite 1905
Philadelphia, PA 19103-6231
Phone
(215) 731-0210
NPI assigned
May 11, 2006
Last updated
Aug 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD048252L PA Primary
Addiction Psychiatry Physician 2084P0802X MD048252L PA

Addresses

Primary practice location

255 S 17TH St
Suite 1905
Philadelphia, PA 19103-6231

Mailing address

255 S 17TH St
Suite 1905
Philadelphia, PA 19103-6231
Phone (215) 731-0210

Other identifiers 1

IdentifierTypeStateIssuer
MD048252LOtherPAMEDICAL LICENSE

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
I20050106000837 PA Practitioner - Psychiatry 9335197284 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
72.79 of 100Reported as group
Quality
41.87
Improvement activities
40
Cost
65.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD048252LPAMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Drexel Academic Medical Group LLC Psychiatry CurrentSince Feb 27, 2022 Accepting new patients
Merakey Philadelphia CurrentSince Oct 15, 2007 Accepting new patients
Drexel University CurrentSince Sep 1, 2022 Accepting new patients
Tower Drexel Academic Medical Group LLC CurrentSince Feb 27, 2022 Accepting new patients
Drexel University CurrentSince Sep 1, 2022 Accepting new patients
Tower Drexel Academic Medical Group LLC Current Accepting new patients
Drexel University Current Accepting new patients
Christiana Care Health Services, Inc Past Accepting new patients
Christiana Care Health Services Inc Past Accepting new patients
Jefferson University Physicians Past Accepting new patients
Merakey Childrens Services Past Accepting new patients

Locations

620 Germantown Pike
Lafayette Hl, PA 19444
Phone (313) 278-2327

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660

219 N Broad St
Fl 6
Philadelphia, PA 19107
Phone (215) 762-5037

255 S 17th St
Ste 1905
Philadelphia, PA 19103
Phone (215) 731-0210

27 E Mount Airy Ave
Philadelphia, PA 19119
Phone (215) 248-6700

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/

Organizations & group practices 11

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1174573869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST",
            "address_2": "SUITE 1905",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036231",
            "telephone_number": "215-731-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST",
            "address_2": "SUITE 1905",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036231",
            "telephone_number": "215-731-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDRICK",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD048252L",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "PA",
            "license": "MD048252L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD048252L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.