Individual provider Active NPI

Ferdinand Andres Aczon, M.D.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1255422135
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD08982L Issued in PA
Practice address
2724 N 5TH St
Philadelphia, PA 19133-2701
Phone
(215) 739-8777
Fax
(215) 739-9016
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD08982L PA Primary

Addresses

Primary practice location

2724 N 5TH St
Philadelphia, PA 19133-2701

Mailing address

204 Summit Rd
Mount Laurel, NJ 08054-4748
Phone (215) 739-8777

Other identifiers 1

IdentifierTypeStateIssuer
0009300270004MedicaidPA

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
I20220727000118 PA Practitioner - Family Practice 0749321255 Practice locations: Philadelphia, PA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD08982LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arun K Mohanty MD, PC Past Accepting new patients
Executive Health Resources Clinical Staffing Solutions PC Past Accepting new patients
Excel Medical Center PastSince Jul 6, 2020 Accepting new patients
Temple Physician Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25233/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255422135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 SUMMIT RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544748",
            "telephone_number": "215-739-8777",
            "fax_number": "215-739-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 N 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191332701",
            "telephone_number": "215-739-8777",
            "fax_number": "215-739-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACZON",
        "first_name": "FERDINAND",
        "middle_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD08982L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009300270004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.