Individual provider Active NPI

Mitra Assadi-Khansari, MD

  • Neurology Physician
  • Philadelphia, PA
National Provider Identifier
1205917952
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD061155L Issued in PA
Practice address
1101 Chestnut St FL 10
Philadelphia, PA 19107-3612
Phone
(215) 955-6000
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD061155L PA Primary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X C1-0013230 DE

Addresses

Primary practice location

1101 Chestnut St FL 10
Philadelphia, PA 19107-3612

Mailing address

901 Walnut St FL 4
Philadelphia, PA 19107-5214
Phone (215) 955-6000

Other identifiers 13

IdentifierTypeStateIssuer
0064051000OtherNJAMERIHEALTH/KEYSTONE/IBC
7712201MedicaidNJ
1010223OtherNJHORIZON NJ HEALTH
0342325OtherNJCIGNA
1883383OtherNJUNITED HEALTH
HORIZON NJ HEALTHOtherNJ1169152
18376OtherNJAMERIHEALTH/PPO PABS
018376OtherNJPA BS HIGHMARK
3K5933OtherNJHEALTHNET
P2182793OtherNJOXFORD
20495OtherNJUNIVERSITY HEALTH PLAN
CA0000306OtherNJAMERICHOICE
3009843OtherNJAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200113000191 DE Practitioner - Neurology 1456530443 Reassigns benefits to 2 organizations
I20251030002835 PA Practitioner - Neurology 1456530443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, shared by 25 NPIs, 1,480 clinicians
Methodist Associates in Healthcare, IncGroup PAC ID 6406755651, 387 clinicians

Practice addresses (Care Compare)

200 Hygeia Dr
Newark, DE 19713-2049
Phone (302) 623-3017

2301 S Broad St
Philadelphia, PA 19148-3542
Phone (215) 952-9300

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 838-3088

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
  • Christiana Hospital Hospital, Newark, DE, CCN 080001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD061155LPAMDNeurology Physician
C1-0013230DEMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Neurology CurrentSince Dec 2, 2019 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Oct 15, 2025 Accepting new patients
Christiana Care Health Services Inc Neurology CurrentSince Dec 2, 2019 Accepting new patients
Christiana Care Health Services Inc Neurology CurrentSince Dec 2, 2019 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Oct 15, 2025 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

200 Hygeia Dr
Ste 1420
Newark, DE 19713
Phone (302) 623-3017

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

774 Christiana Rd
Ste 201
Newark, DE 19713
Phone (302) 623-3017

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

1101 Chestnut St
Fl 10
Philadelphia, PA 19107
Phone (215) 587-3000

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1205917952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WALNUT ST FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075214",
            "telephone_number": "215-955-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 CHESTNUT ST FL 10",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073612",
            "telephone_number": "215-955-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSADI-KHANSARI",
        "first_name": "MITRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD061155L",
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "DE",
            "license": "C1-0013230",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/KEYSTONE/IBC",
            "identifier": "0064051000",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7712201",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1010223",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0342325",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "1883383",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1169152",
            "identifier": "HORIZON NJ HEALTH",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/PPO PABS",
            "identifier": "18376",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BS HIGHMARK",
            "identifier": "018376",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3K5933",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2182793",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY HEALTH PLAN",
            "identifier": "20495",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "CA0000306",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3009843",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.