NPIMap

Drexel University

Organization Active NPI Family Medicine Physician · Philadelphia, PA

NPI 1356458772 · NPPES record last updated Jun 9, 2022

Key facts

NPI
1356458772
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
DREXEL UNIVERSITY
Practice address
3401 Market St Ste 105B
Philadelphia, PA 19104-3315
Phone
(215) 220-4700
NPI assigned
Aug 23, 2006
Organization subpart
No

Authorized official

Name
Edward Waldov
Title
Director of Revenue Cycle - Finance
Phone
(215) 255-7751

Other NPIs on the same Medicare enrollment 45

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 45

Corporate family (same tax ID) 20

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

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140729001682 PA Part B Supplier - Clinic/Group Practice 5496664740 Receives reassigned benefits from 340 practitioners
45 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA; Warminster, PA; Elkins Park, PA

National Provider Directory

Tax ID family
Drexel University (21 organizations share this tax ID)

Locations

1601 Cherry St
Ste 11511
Philadelphia, PA 19102

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X PA Yes
Sports Medicine (Family Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207QS0010X
Geriatric Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RG0300X

Addresses

Primary practice location

3401 Market St Ste 105B
Philadelphia, PA 19104-3315

Mailing address

1601 Cherry St Ste 11511
Philadelphia, PA 19102-1310
Phone (215) 255-7751

Other practice location 1

10 Shurs Ln
Suite 203
Philadelphia, PA 19127-2123
Phone (215) 482-1234

Other names

  • Drexel Family Medicine Doing business as

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.