Individual provider Active NPI

Irina Staicu, DO, MMS

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1265846034
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS018048 Issued in PA
Practice address
1420 Walnut St Ste 904
Philadelphia, PA 19102
Phone
(215) 735-8052
Fax
(215) 735-5323
NPI assigned
Jun 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS018048 PA Primary
Physical Medicine & Rehabilitation Physician 208100000X OS018048 PA

Addresses

Primary practice location

1420 Walnut St Ste 904
Philadelphia, PA 19102

Mailing address

111 Chestnut St Unit 212
Cherry Hill, NJ 08002-1836
Phone (856) 580-3368

Other practice location 1

6722 Bustleton Ave Ste 5
Philadelphia, PA 19149-2341
Phone (215) 735-0400

Other practice location 2

1335 W Tabor Rd Ste 205
Philadelphia, PA 19141-3040
Phone (215) 735-6210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS018048PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center City Medical Center Internal Medicine Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1265846034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CHESTNUT ST UNIT 212",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080021836",
            "telephone_number": "856-580-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 WALNUT ST STE 904",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-735-8052",
            "fax_number": "215-735-5323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6722 Bustleton Ave Ste 5",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191492341",
            "country_code": "US",
            "telephone_number": "215-735-0400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1335 W Tabor Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413040",
            "country_code": "US",
            "telephone_number": "215-735-6210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAICU",
        "first_name": "IRINA",
        "name_prefix": "Dr.",
        "credential": "DO, MMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS018048",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "OS018048",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.