Individual provider Active NPI

Nielufar Varjavand, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1316990369
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD064234L Issued in PA
Practice address
219 N Broad St
8TH FL
Philadelphia, PA 19107-1519
Phone
(215) 762-5037
Fax
(215) 762-5199
NPI assigned
May 19, 2006
Last updated
Mar 19, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD064234L PA Primary

Addresses

Primary practice location

219 N Broad St
8TH FL
Philadelphia, PA 19107-1519

Mailing address

1601 Cherry St
Suite 11511
Philadelphia, PA 19102-1321
Phone (215) 255-7822

Other identifiers 1

IdentifierTypeStateIssuer
001713333MedicaidPA

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
I20050502001139 PA Practitioner - Internal Medicine 1456390137 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
George Washington University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drexel UniversityGroup PAC ID 5496664740, 80 clinicians

Practice addresses (Care Compare)

1427 Vine St
Philadelphia, PA 19102-1031

219 N Broad St 6TH Floor
Drexel Internal Medicine
Philadelphia, PA 19107-1519
Phone (215) 762-5037

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Drexel University CurrentSince Jul 1, 2014 Accepting new patients
Tower Drexel Academic Medical Group LLC CurrentSince Apr 1, 2020 Accepting new patients
Drexel University CurrentSince Jul 1, 2014 Accepting new patients
Tower Drexel Academic Medical Group LLC Internal Medicine CurrentSince Apr 1, 2020 Accepting new patients
Drexel University Current Accepting new patients

Locations

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

1601 Cherry St
Ste 11511
Philadelphia, PA 19102

219 N Broad St
Fl 6
Philadelphia, PA 19107
Phone (215) 762-5037

219 N Broad St
Fl 9
Philadelphia, PA 19107
Phone (215) 762-2688

219 N Broad St
Ste 8
Philadelphia, PA 19107
Phone (215) 762-4005

Interoperability endpoints

  • Direct secure messaging: nvarjavand18998@drexel.gardenplot.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1316990369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021321",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N BROAD ST",
            "address_2": "8TH FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071519",
            "telephone_number": "215-762-5037",
            "fax_number": "215-762-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARJAVAND",
        "first_name": "NIELUFAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD064234L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001713333",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.