Andrew A Badulak, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

05006960E Issued in PA

Practice address

700 S Henderson Rd
Ste 308C
King of Prussia, PA 19406

Phone

(610) 337-3111

Fax

(610) 337-3506

NPI assigned

Sep 7, 2006

Last updated

Apr 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Family Practice

Education

University of New England, College of Osteo Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Roy M Lerman M D P CGroup PAC ID 5890775878, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Roy M Lerman MD PC

  dba Main Line Spine

  • Physical Medicine & Rehabilitation Physician
  • King of Prussia, PA
  • NPI 1215030812
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1225131824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S HENDERSON RD",
            "address_2": "STE 308C",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "19406",
            "telephone_number": "610-337-3111",
            "fax_number": "610-337-3506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S HENDERSON RD",
            "address_2": "STE 308C",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "19406",
            "telephone_number": "610-337-3111",
            "fax_number": "610-337-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADULAK",
        "first_name": "ANDREW",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "05006960E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "588258",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrew.badulak@mls.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "700 S Henderson Rd",
            "address_2": "Ste 308C",
            "city": "King of Prussia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "19406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Morton L Axelrod, PHD
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• Peggy Caren Backal, PSYD
• Tanya Backlund, MED, BCBA, LBS
• Masuma Bahora, MD
• Carli Bailey
• Jennie Odessa Balan
• Balance and Vestibular Center of King of Prussia LLC
• Balboa Pharmacy LLC

• Family Medicine Physician in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.