Individual provider Active NPI

Krisda H Chaiyachati, MD, MPH

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1174812366
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD453616 Issued in PA
Practice address
3900 Woodland Ave
Philadelphia, PA 19104-4551
Phone
(215) 823-5800
NPI assigned
Mar 29, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 052881 CT
Internal Medicine Physician 207R00000X MD453616 PA Primary

Addresses

Primary practice location

3900 Woodland Ave
Philadelphia, PA 19104-4551

Mailing address

423 Guardian Dr
1301 Blockley Hall
Philadelphia, PA 19104-4865
Phone (215) 573-9328

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
I20151231001484 PA Practitioner - HospitalistPractitioner - Internal Medicine 4183848823 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
University of Michigan Medical School, 2011
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)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-4000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Sep 4, 2018 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Internal Medicine Current Accepting new patients
University of Penn - Medical Group Internal Medicine Current Accepting new patients
Lancaster General Medical Group CurrentSince Jul 2, 2019 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Internal Medicine CurrentSince Sep 4, 2018 Accepting new patients
University of Penn-Medical Group Internal Medicine CurrentSince Nov 10, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince Nov 10, 2015 Accepting new patients
Lancaster General Medical Group CurrentSince Jul 2, 2019 Accepting new patients
Trustees of the University of Pennsylvania Internal Medicine Past Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Lancaster General Medical Group Past Accepting new patients

Locations

620 Spear St
Oxford, PA 19363
Phone (610) 932-9300

3400 Civic Center Blvd
Fl 1E
Philadelphia, PA 19104
Phone (215) 615-5252

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

3400 Spruce St
Fl 5
Philadelphia, PA 19104
Phone (215) 662-2777

3701 Market St
Fl 6
Philadelphia, PA 19104
Phone (215) 662-2250

1800 Lombard St
Ste 206
Philadelphia, PA 19146
Phone (215) 615-2222

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Interoperability endpoints

  • Direct secure messaging: kchaiyachati@direct.wtbyhosp.org

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1174812366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 GUARDIAN DR",
            "address_2": "1301 BLOCKLEY HALL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044865",
            "telephone_number": "215-573-9328"
        },
        {
            "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": [],
    "basic": {
        "last_name": "CHAIYACHATI",
        "first_name": "KRISDA",
        "middle_name": "H",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-29",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "052881",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD453616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.