Brian Dale Crispell

Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Media, PA

NPI 1306806765 · NPPES record last updated Jun 13, 2014

Key facts

NPI
1306806765
Entity type
Individual (NPI type 1)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
License
SC005698 (PA)
Practice address
1078 W Baltimore Pike
Riddle Health Center 1, Suite 209
Media, PA 19063-5105
Phone
(610) 334-7657
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

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 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Podiatry
Education
Temple University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delaware County Foot and Ankle Center, P.C. (2 clinicians)

Practice addresses (Care Compare)

100 Granite Dr
Suite 4
Media, PA 19063-5170
Phone (610) 334-7657

550 Macdade Blvd
Folsom, PA 19033-2308
Phone (610) 534-7990

Hospital & facility affiliations

  • Main Line Health Home Care & Hospice - Home Health Home health agency · Radnor, PA · CCN 397012
  • Riddle Memorial Hospital Hospital · Media, PA · CCN 390222
  • Bryn Mawr Hospital Hospital · Bryn Mawr, PA · CCN 390139
  • Main Line Hospital Lankenau Hospital · Wynnewood, PA · CCN 390195

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue69
Removal of nail tissue75
Removal or shaving of skin growth1-10

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20060410000523 PA Practitioner - Podiatry 8426067000 Reassigns benefits to 1 organization
Practice locations: Media, PA

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
SC005698PAMDSports Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware County Foot and Ankle Center, P.C. Podiatrist Current
since Jan 14, 2014
Accepting new patients

Locations

550 Macdade Blvd
Folsom, PA 19033
Phone (610) 534-7990

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC005698 PA
Primary Podiatric Medicine Podiatrist 213EP1101X SC005698 PA
Sports Medicine Podiatrist 213ES0000X SC005698 PA
Foot & Ankle Surgery Podiatrist 213ES0103X SC005698 PA Yes

Addresses

Primary practice location

1078 W Baltimore Pike
Riddle Health Center 1, Suite 209
Media, PA 19063-5105

Mailing address

2301 Green St
Apt 8
Philadelphia, PA 19130-3143
Phone (610) 334-7657

Other identifiers

IdentifierTypeStateIssuer
1015531700005MedicaidPA
329832OtherPAMEDICARE PTAN

Other names

  • Brian Crispell Professional name

Other providers in Media, PA

All providers in Media, PA · Foot & Ankle Surgery Podiatrist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.