Individual provider Active NPI

Edan Zitelny, MD

  • Student in an Organized Health Care Education/Training Program
  • Philadelphia, PA
National Provider Identifier
1235713157
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3400 Spruce St
Philadelphia, PA 19104-4238
Phone
(215) 823-4133
Fax
(215) 823-4545
NPI assigned
May 6, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4238

Mailing address

2048 Locust St Apt 200
Philadelphia, PA 19103-5614

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
I20240610003003 PA Practitioner - Internal Medicine 5395125371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of the University of Pennsylvania CurrentSince Jun 24, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 23, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 23, 2024 Accepting new patients
University of Penn - Medical Group Current Accepting new patients
Presbyterian Medical Center of the University of Pennsylvania Health S Past Accepting new patients

Locations

3701 Market St
Ste 640
Philadelphia, PA 19104
Phone (215) 662-2250

3701 Market St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-2250

Organizations & group practices 5

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": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1235713157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2048 LOCUST ST APT 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191035614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-823-4133",
            "fax_number": "215-823-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZITELNY",
        "first_name": "EDAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.