Individual provider Active NPI

Miriam Olga Anolik, MD

  • Pediatrics Physician
  • Bala Cynwyd, PA
National Provider Identifier
1366524043
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD019870E Issued in PA
Practice address
25 Bala Ave Ste 102
Bala Cynwyd, PA 19004-3214
Phone
(215) 452-0304
Fax
(215) 452-0311
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD019870E PA Primary

Addresses

Primary practice location

25 Bala Ave Ste 102
Bala Cynwyd, PA 19004-3214

Mailing address

25 Bala Ave Ste 102
Bala Cynwyd, PA 19004-3214
Phone (215) 452-0304

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
I20110427000107 PA Practitioner - Pediatric Medicine 4082899547

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2085 N 63Rd St
Philadelphia, PA 19151-2675

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Philadelphia Health Associates-Pediatrics, PC Pediatrics CurrentSince May 1, 2011 Accepting new patients
Plastic & Cosmetic Surgery Institute PC PastSince Jun 2, 2010 Accepting new patients

Locations

25 Bala Ave
Ste 102
Bala Cynwyd, PA 19004
Phone (215) 452-0304

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAJDBA/Endpoint/JAJDBA

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1366524043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BALA AVE STE 102",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043214",
            "telephone_number": "215-452-0304",
            "fax_number": "215-452-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BALA AVE STE 102",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043214",
            "telephone_number": "215-452-0304",
            "fax_number": "215-452-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANOLIK",
        "first_name": "MIRIAM",
        "middle_name": "OLGA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD019870E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

Verify at the official NPI Registry.