NPIMap

Individual provider Active NPI

Nicholas Theodoropoulos, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1356801153
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD476917 Issued in PA
Practice address
800 Walnut St FL 16
Philadelphia, PA 19107-5176
Phone
(215) 829-0101
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD476917 PA Primary

Addresses

Primary practice location

800 Walnut St FL 16
Philadelphia, PA 19107-5176

Mailing address

800 Walnut St FL 16
Philadelphia, PA 19107-5176
Phone (215) 829-0101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220803000051 PA Practitioner - Internal Medicine 9537490628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Cooper Medical School of Rowan University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

800 Walnut St FL
16 Internal Med Spruce
Philadelphia, PA 19107-5176
Phone (215) 829-0101

Hospital & facility affiliations

  • Penn Medicine Home Health Home health agency, Bala Cynwyd, PA, CCN 397125
  • Jefferson Health at Home by Bayada Home health agency, Philadelphia, PA, CCN 397643
  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • Good Shepherd Penn Partners Long-term care hospital, Philadelphia, PA, CCN 392050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health Internal Medicine CurrentSince Sep 12, 2022 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Sep 12, 2022 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Internal Medicine Past Accepting new patients
Johnson Upper Extremity OT Services, PC Past Accepting new patients

Locations

800 Walnut St
Fl 16
Philadelphia, PA 19107
Phone (215) 829-0101

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 4

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 7

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1356801153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WALNUT ST FL 16",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075176",
            "telephone_number": "215-829-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WALNUT ST FL 16",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075176",
            "telephone_number": "215-829-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODOROPOULOS",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD476917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.