Individual provider Active NPI

Marwan Badri, M.D.

  • Interventional Cardiology Physician
  • Wynnewood, PA
National Provider Identifier
1265744908
Registry record updated Jun 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD456972 Issued in PA
Practice address
100 E Lancaster Ave
Suite 4303
Wynnewood, PA 19096-3450
Phone
(484) 476-6421
Fax
(484) 476-3149
NPI assigned
Jul 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT196486 PA
Interventional Cardiology Physician 207RI0011X MD456972 PA Primary
Hospitalist Physician 208M00000X MD456972 PA
Cardiovascular Disease Physician 207RC0000X MD456972 PA

Addresses

Primary practice location

100 E Lancaster Ave
Suite 4303
Wynnewood, PA 19096-3450

Mailing address

1088 W Baltimore Pike
Ste 2500
Media, PA 19063-5166
Phone (484) 476-6421

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
I20161201001164 PA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Hospitalist 7416237870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1088 W Baltimore Pike
Suite 2500
Media, PA 19063-5166
Phone (610) 565-4107

Hospital & facility affiliations

  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting156
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT196486PAMDInternal Medicine Physician
MD456972PAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Internal Medicine CurrentSince Nov 1, 2016 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

2000 Old West Chester Pike
Havertown, PA 19083
Phone (610) 536-2100

1088 W Baltimore Pike
Ste 2500
Media, PA 19063
Phone (610) 565-2449

1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400

100 E Lancaster Ave
Ste 356
Wynnewood, PA 19096
Phone (484) 476-2684

100 E Lancaster Ave
Ste 4303
Wynnewood, PA 19096
Phone (484) 476-6421

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 1

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 6

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": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496275200000",
    "number": "1265744908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1088 W BALTIMORE PIKE",
            "address_2": "STE 2500",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635166",
            "telephone_number": "484-476-6421",
            "fax_number": "484-476-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 4303",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-6421",
            "fax_number": "484-476-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADRI",
        "first_name": "MARWAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-10",
        "last_updated": "2017-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT196486",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "MD456972",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD456972",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD456972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.