Individual provider Active NPI

Andres Enriquez, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Philadelphia, PA
National Provider Identifier
1336508332
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
MD456730 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104-4238
Phone
(215) 662-2884
NPI assigned
Feb 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X MD456730 PA Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4238

Mailing address

3400 Civic Center Blvd
East Pavilion, 2ND Floor
Philadelphia, PA 19104-4306
Phone (215) 662-3999

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
I20231221000700 PA Practitioner - Cardiac Electrophysiology 1850741562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-7355

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Clinical Cardiac Electrophysiology CurrentSince Dec 1, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Dec 1, 2023 Accepting new patients

Locations

3400 Civic Center Blvd
Ste 2E
Philadelphia, PA 19104
Phone (215) 615-0820

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1336508332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "EAST PAVILION, 2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044306",
            "telephone_number": "215-662-3999",
            "fax_number": "215-615-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-18",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "PA",
            "license": "MD456730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.