Individual provider Active NPI

Vanessa N. Madrigal, M.D.

  • Pediatric Critical Care Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1194915330
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
MD430803 Issued in PA
Practice address
34TH Street & Civic Center Blvd
Suite 9329
Philadelphia, PA 19104-4399
Phone
(215) 590-1858
Fax
(215) 590-3934
NPI assigned
Jul 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X MD430803 PA Primary

Addresses

Primary practice location

34TH Street & Civic Center Blvd
Suite 9329
Philadelphia, PA 19104-4399

Mailing address

100 East Penn Square
The Wanamaker Building, 9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9300

Other identifiers 2

IdentifierTypeStateIssuer
1024895660001MedicaidPA
191470EMDOtherPAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20140924001878 DC Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 4183810351 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD430803PAMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital CurrentSince Jul 25, 2014 Accepting new patients
Children'S Hospital CurrentSince Jul 25, 2014 Accepting new patients
Children'S Hospital Current Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

Organizations & group practices 3

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": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1194915330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EAST PENN SQUARE",
            "address_2": "THE WANAMAKER BUILDING, 9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9300",
            "fax_number": "267-425-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34TH STREET & CIVIC CENTER BLVD",
            "address_2": "SUITE 9329",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044399",
            "telephone_number": "215-590-1858",
            "fax_number": "215-590-3934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADRIGAL",
        "first_name": "VANESSA",
        "middle_name": "N.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "PA",
            "license": "MD430803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024895660001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "191470EMD",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.