Individual provider Active NPI

Andrej Lyshchik, M.D., PH.D.

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1356534895
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD445598 Issued in PA
Practice address
111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824
Phone
(215) 955-6226
Fax
(215) 923-1562
NPI assigned
Aug 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X MD445598 PA
Diagnostic Radiology Physician 2085R0202X MD445598 PA Primary
Diagnostic Radiology Physician 2085R0202X 46419 TN

Addresses

Primary practice location

111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824

Mailing address

111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824
Phone (215) 955-6226

Other identifiers 2

IdentifierTypeStateIssuer
102711579MedicaidPA
0309834MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120601000083 PA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 2163600081 Reassigns benefits to 6 organizations
I20180710000033 NJ Practitioner - Diagnostic Radiology 2163600081 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University Radiology Associates LLCGroup PAC ID 7315845708, shared by 3 NPIs, 110 clinicians
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians
Jeanes Radiology Associates LLCGroup PAC ID 1850290248, 43 clinicians
Jefferson University Physicians of New Jersey PCGroup PAC ID 9931325131, 117 clinicians

Practice addresses (Care Compare)

1 W Germantown Pike
East Norriton, PA 19401-1513
Phone (610) 277-3202

10160 Bustleton Ave E
Jefferson Outpatient Imaging
Philadelphia, PA 19116-3749
Phone (215) 503-4900

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-4000

1101 Chestnut St
Philadelphia, PA 19107-3619
Phone (800) 533-3669

1101 Market St
FL 19
Philadelphia, PA 19107-2926

111 S 11TH St
Philadelphia, PA 19107-4824

1200 Old York Rd
Abington, PA 19001-3720

1619 Grant Ave
Philadelphia, PA 19115-3167
Phone (215) 676-3300

2211 Chapel Ave W
Suite 403
Cherry Hill, NJ 08002-2048
Phone (856) 922-5030

2301 S Broad St
Philadelphia, PA 19148-3542
Phone (215) 952-7444

3 Crescent Dr
Suite 1002
Philadelphia, PA 19112-1016
Phone (215) 503-4900

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 582-2500

443 Laurel Oak Rd
Voorhees, NJ 08043-4419

534 2ND Ave
Suite 102
Collegeville, PA 19426-2654
Phone (610) 831-0500

650 Carnegie Blvd
Suite 240
Malvern, PA 19355-8519
Phone (215) 503-4900

834 Walnut St
Suite 110
Philadelphia, PA 19107-5109
Phone (215) 503-4779

850 Walnut St
Philadelphia, PA 19107-5109

925 Chestnut St
Philadelphia, PA 19107-4204

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

999 Route 73 N 101
Jefferson Outpatient Imaging
Marlton, NJ 08053-1227
Phone (856) 424-2929

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
  • Jefferson Abington Hospital Hospital, Abington, PA, CCN 390231
  • Jefferson Lansdale Hospital Hospital, Lansdale, PA, CCN 390012
  • Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46419TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jeanes Radiology Associates LLC Diagnostic Radiology CurrentSince Jul 24, 2020 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Sep 3, 2019 Accepting new patients
Lebanon Diagnostic Imaging, LLC Diagnostic Radiology CurrentSince Jul 24, 2020 Accepting new patients
Rittenhouse Imaging Center, LLC Diagnostic Radiology CurrentSince Jul 24, 2020 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Jul 1, 2012 Accepting new patients
Jefferson University Physicians of New Jersey, P.C. CurrentSince May 28, 2018 Accepting new patients
Jefferson University Radiology Associates LLC Diagnostic Radiology CurrentSince Jul 1, 2012 Accepting new patients
Jefferson University Physicians Diagnostic Radiology CurrentSince Jul 1, 2012 Accepting new patients
Insight Health Corp PastSince Jul 24, 2020 Accepting new patients

Locations

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

999 Route 73 N
Ste 101
Marlton, NJ 08053
Phone (856) 424-2929

443 Laurel Oak Rd
Ste 130
Voorhees, NJ 08043
Phone (856) 741-0122

462 Gateway Ave
Chambersburg, PA 17201
Phone (717) 263-4999

150 E Pennsylvania Ave
Downingtown, PA 19335
Phone (215) 772-9674

800 W State St
Ste 203
Doylestown, PA 18901
Phone (215) 345-4568

111 S 11th St
#3390
Philadelphia, PA 19107
Phone (215) 955-2900

111 S 11th St
Ste 3390
Philadelphia, PA 19107
Phone (215) 955-2900

850 Walnut St
Philadelphia, PA 19107
Phone (215) 503-4900

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 10

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 5

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": "1187395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1356534895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6226",
            "fax_number": "215-923-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6226",
            "fax_number": "215-923-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYSHCHIK",
        "first_name": "ANDREJ",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-18",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MD445598",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD445598",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "46419",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102711579",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0309834",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.