Individual provider Active NPI

Sallyanna Bazelais, DO

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1346980240
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS025464 Issued in PA
Practice address
7131 Frankford Ave # 39
Philadelphia, PA 19135-1008
Phone
(215) 332-4164
Fax
(215) 332-9638
NPI assigned
Mar 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Family Medicine Physician 207Q00000X OS025464 PA Primary

Addresses

Primary practice location

7131 Frankford Ave # 39
Philadelphia, PA 19135-1008

Mailing address

PO Box 788735
Philadelphia, PA 19178-8735
Phone (215) 456-7000

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
I20260401001662 PA Practitioner - Family Practice 7618452236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, New York, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Community Health Associates IncGroup PAC ID 7012818008, 196 clinicians

Practice addresses (Care Compare)

7131 -39 Frankford Ave
Philadelphia, PA 19135-1008
Phone (215) 332-4164

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS025464PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Community Health Associates, Inc Family Medicine CurrentSince Feb 7, 2026 Accepting new patients
Einstein Community Health Associates, Inc PastSince Feb 7, 2026 Accepting new patients

Locations

7131 Frankford Ave
Philadelphia, PA 19135
Phone (215) 332-4164

7131 Frankford Ave
#39
Philadelphia, PA 19135
Phone (215) 332-4164

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.

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1346980240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788735",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191788735",
            "telephone_number": "215-456-7000",
            "fax_number": "215-254-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7131 FRANKFORD AVE # 39",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191351008",
            "telephone_number": "215-332-4164",
            "fax_number": "215-332-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZELAIS",
        "first_name": "SALLYANNA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS025464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.