Individual provider Active NPI

Robert Watson Ford, MD

  • Vascular & Interventional Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1265875314
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD466990 Issued in PA
Practice address
111 S 11TH St
Philadelphia, PA 19107-4824
Phone
(215) 955-6000
NPI assigned
Apr 8, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X MT204522 PA
Student in an Organized Health Care Education/Training Program 390200000X
Vascular & Interventional Radiology Physician 2085R0204X MD466990 PA Primary

Addresses

Primary practice location

111 S 11TH St
Philadelphia, PA 19107-4824

Mailing address

1025 Walnut St
Suite 801
Philadelphia, PA 19107-5001
Phone (215) 955-8768

Other practice location 1

833 Chestnut St
Suite 301
Philadelphia, PA 19107-4414
Phone (215) 955-6180

Other practice location 2

380 N Oxford Valley Rd
Langhorne, PA 19047-8304
Phone (215) 949-5111

Other practice location 3

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-4811

Other practice location 4

4900 Frankford Ave
Philadelphia, PA 19124-2618
Phone (215) 831-2063

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
I20190619001460 PA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 6002039344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

1101 Market St
FL 19
Philadelphia, PA 19107-2926

111 S 11TH St
Philadelphia, PA 19107-4824

2301 S Broad St
Philadelphia, PA 19148-3542
Phone (215) 952-7444

909 Walnut St
2ND Floor
Philadelphia, PA 19107-5211
Phone (215) 955-7000

925 Chestnut St
Philadelphia, PA 19107-4204

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Feb 1, 2020 Accepting new patients
Bryn Mawr Imaging Past Accepting new patients
Main Line Health Imaging LP PastSince Jul 1, 2019 Accepting new patients
Jefferson University Hospital Past Accepting new patients

Locations

380 N Oxford Valley Rd
Langhorne, PA 19047
Phone (215) 949-5000

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

4900 Frankford Ave
Philadelphia, PA 19124
Phone (215) 612-2610

833 Chestnut St
Ste 301
Philadelphia, PA 19107
Phone (215) 955-2363

10800 Knights Rd
Philadelphia, PA 19114
Phone (215) 612-2610

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.

Hospital & facility affiliations 1

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": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1265875314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 WALNUT ST",
            "address_2": "SUITE 801",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075001",
            "telephone_number": "215-955-8768",
            "fax_number": "215-955-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 Chestnut St",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074414",
            "country_code": "US",
            "telephone_number": "215-955-6180",
            "fax_number": "215-955-6410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "380 N Oxford Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Langhorne",
            "state": "PA",
            "postal_code": "190478304",
            "country_code": "US",
            "telephone_number": "215-949-5111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10800 Knights Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191144200",
            "country_code": "US",
            "telephone_number": "215-612-4811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4900 Frankford Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191242618",
            "country_code": "US",
            "telephone_number": "215-831-2063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD",
        "first_name": "ROBERT",
        "middle_name": "WATSON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-08",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MT204522",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MD466990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.