NPIMap

Organization Active NPI

Philadelphia VA Medica Center

  • Medical Specialty Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1326188970
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
086131 Issued in OH
Legal business name
PHILADELPHIA VA MEDICA CENTER
Practice address
Padrecc , Philadelphia VA Medical Center
University and Woodland Avenue
Philadelphia, PA 19104
Phone
(215) 823-5800
Fax
(215) 823-4603
NPI assigned
Feb 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Adrian T Chan, M.D.
Title
Fellow
Phone
(215) 823-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 086131 OH Primary

Addresses

Primary practice location

Padrecc , Philadelphia VA Medical Center
University and Woodland Avenue
Philadelphia, PA 19104

Mailing address

4816 Pine St
Apt B202
Philadelphia, PA 19143-1721
Phone (215) 748-1346

National Provider Directory

National Provider Directory
Tax ID family
Philadelphia Vamc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326188970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4816 PINE ST",
            "address_2": "APT B202",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431721",
            "telephone_number": "215-748-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PADRECC , PHILADELPHIA VA MEDICAL CENTER",
            "address_2": "UNIVERSITY AND WOODLAND AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-823-5800",
            "fax_number": "215-823-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA VA MEDICA CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "FELLOW",
        "authorized_official_telephone_number": "215-823-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OH",
            "license": "086131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.