Individual provider Active NPI

Elizabeth W Fletman, DO

  • Neurology Physician
  • Philadelphia, PA
National Provider Identifier
1245819192
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
OT020552 Issued in PA
Practice address
901 Walnut St FL 4
Philadelphia, PA 19107-5214
Phone
(215) 955-9425
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X OT020552 PA Primary

Addresses

Primary practice location

901 Walnut St FL 4
Philadelphia, PA 19107-5214

Mailing address

701 S 7TH St Unit 2
Philadelphia, PA 19147-2118
Phone (215) 760-2716

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
I20210519000560 PA Order and Referring Only - NeurologyPractitioner - Neurology 9830507540

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1245819192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S 7TH ST UNIT 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191472118",
            "telephone_number": "215-760-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WALNUT ST FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075214",
            "telephone_number": "215-955-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETMAN",
        "first_name": "ELIZABETH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "OT020552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.