Active NPI
Brian D Fedgchin, MD
- Cardiovascular Disease Physician
- Phila, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MD072666L
- Practice address
- 2422 S Broad St
1St Floor
Phila, PA 19145-4418 - Phone
- (215) 389-1748
- Fax
- (215) 389-0604
- NPI assigned
- Dec 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 25MA07513800 | NJ | |
| Cardiovascular Disease Physician | 207RC0000X | MD072666L | PA | Primary |
Addresses
Primary practice location
2422 S Broad St
1St Floor
Phila, PA 19145-4418
Mailing address
2422 S Broad St
1St Floor
Phila, PA 19145-4418
Phone (215) 389-1748
Other practice location 1
3 Crescent Dr Fl 4
Philadelphia, PA 19112-1016
Phone (215) 503-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0018594810005 | Medicaid | PA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Georgetown University School of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1101 Chestnut St
Philadelphia, PA 19107-3619
Phone (800) 533-3669
111 S 11TH St
Suite 8490
Philadelphia, PA 19107-4824
Phone (215) 955-6161
2301 S Broad St
Philadelphia, PA 19148-3542
3 Crescent Dr
Philadelphia, PA 19112-1016
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA07513800 | NJ | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Associates in Healthcare, Inc | Current | Accepting new patients | |
| Jefferson University Physicians | Current | Accepting new patients | |
| Jefferson University Physicians | Past | Accepting new patients | |
| Aria Health Physician Services | Past | Accepting new patients | |
| Cardiovascular Associates of the Delaware Valley,P a | Cardiovascular Disease | Past | Accepting new patients |
Locations
443 Laurel Oak Rd
Ste 100
Voorhees, NJ 08043
Phone (215) 955-5050
443 Laurel Oak Rd
Voorhees, NJ 08043
Phone (215) 456-4985
1200 York Rd
Abington, PA 19001
Phone (215) 481-2222
111 S 11th St
Ste 8490
Philadelphia, PA 19107
Phone (215) 955-6161
1101 Chestnut St
Fl 9
Philadelphia, PA 19107
Phone (215) 503-1807
925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760
3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060
3 Crescent Dr
#4
Philadelphia, PA 19112
2422 S Broad St
#1
Philadelphia, PA 19145
Phone (215) 389-0600
1015 Chestnut St
Ste 1400
Philadelphia, PA 19107
Phone (215) 955-2920
2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000
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.
-
- Family Medicine Physician
- Philadelphia, PA
- NPI 1053355131
-
- General Practice Physician
- Philadelphia, PA
- NPI 1326093675
-
dba Geoffrey W. Temple Family Medical Associates
- Family Medicine Physician
- Philadelphia, PA
- NPI 1053181297
-
dba Jefferson GI
- Gastroenterology Physician
- Phila, PA
- NPI 1205898723
-
- Cardiovascular Disease Physician
- Haddon Heights, NJ
- NPI 1366495632
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1215916002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542758400000",
"number": "1336124221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2422 S BROAD ST",
"address_2": "1ST FLOOR",
"city": "PHILA",
"state": "PA",
"postal_code": "191454418",
"telephone_number": "215-389-1748",
"fax_number": "215-389-0604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2422 S BROAD ST",
"address_2": "1ST FLOOR",
"city": "PHILA",
"state": "PA",
"postal_code": "191454418",
"telephone_number": "215-389-1748",
"fax_number": "215-389-0604"
}
],
"practiceLocations": [
{
"address_1": "3 Crescent Dr Fl 4",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191121016",
"country_code": "US",
"telephone_number": "215-503-3300",
"fax_number": "215-503-3321",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FEDGCHIN",
"first_name": "BRIAN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-13",
"last_updated": "2018-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NJ",
"license": "25MA07513800",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "PA",
"license": "MD072666L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0018594810005",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phila, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.