Individual provider Active NPI

Che Damon Ward, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1306084108
Registry record updated Jun 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD439564 Issued in PA
Practice address
5501 Old York Rd
Korman B-6
Philadelphia, PA 19141-3018
Phone
(215) 456-8037
NPI assigned
Feb 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X MD439564 PA Primary

Addresses

Primary practice location

5501 Old York Rd
Korman B-6
Philadelphia, PA 19141-3018

Mailing address

243 E Maujer St
Valley Stream, NY 11580-4731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20140701001144 CT Practitioner - Emergency Medicine 6507980117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York Downstate Medical Center, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridgeport HospitalGroup PAC ID 2062312598, 134 clinicians

Practice addresses (Care Compare)

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeport Hospital CurrentSince Jun 26, 2023 Accepting new patients
Bridgeport Hospital Current Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Mar 27, 2022 Accepting new patients
Bridgeport Hospital CurrentSince Jun 26, 2023 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Mar 27, 2022 Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

Interoperability endpoints

  • Direct secure messaging: cward2389335@direct.trinity-health.org
  • Direct secure messaging: cward620017@direct.ynhh.org

Organizations & group practices 5

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 2

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": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276473600000",
    "number": "1306084108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 E MAUJER ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "KORMAN B-6",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "CHE",
        "middle_name": "DAMON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-02",
        "last_updated": "2010-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD439564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.