Individual provider Active NPI

Ronald Anthony Codario Sr., M.D.

  • Cardiovascular Disease Physician
  • Philadelphia, PA
National Provider Identifier
1295892107
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD015340-E Issued in PA
Practice address
2511 S Broad St
Philadelphia, PA 19148-4309
Phone
(215) 467-3883
Fax
(215) 467-2911
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD015340-E PA Primary

Addresses

Primary practice location

2511 S Broad St
Philadelphia, PA 19148-4309

Mailing address

2511 S Broad St
Philadelphia, PA 19148-4309
Phone (215) 467-3883

Other identifiers 4

IdentifierTypeStateIssuer
0055123000OtherPABLUE SHIELD PERS CHOICE
0055123000OtherPAPA BLUE SHIELD
0076334003OtherPAAMERICHOICE OF PA
1039424OtherPAKEYSTONE MERCY

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
I20120228000695 PA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Peripheral Vascular Disease 4587822135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD015340-EPAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stang Medical Services LLC CurrentSince Dec 13, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2511 S Broad St
Philadelphia, PA 19148
Phone (215) 467-3883

Organizations & group practices 2

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1295892107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191484309",
            "telephone_number": "215-467-3883",
            "fax_number": "215-467-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191484309",
            "telephone_number": "215-467-3883",
            "fax_number": "215-467-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CODARIO",
        "first_name": "RONALD",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD015340-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PERS CHOICE",
            "identifier": "0055123000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "0055123000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE OF PA",
            "identifier": "0076334003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1039424",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.