Individual provider Active NPI

Ghazal Zekavat Quinn

  • Nephrology Physician
  • Wynnewood, PA
National Provider Identifier
1366837759
Registry record updated Oct 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD470935 Issued in PA
Practice address
100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone
(484) 476-2000
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nephrology Physician 207RN0300X MD470935 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X MT209174 PA

Addresses

Primary practice location

100 E Lancaster Ave
Wynnewood, PA 19096-3450

Mailing address

3400 Spruce St
5 White
Philadelphia, PA 19104-4238
Phone (215) 662-2638

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
I20201008000501 PA Practitioner - Nephrology 4082902333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd 1 S Pavilion
Nephrology/Hypertension Perelman Center
Philadelphia, PA 19104-4306
Phone (215) 662-2638

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Jul 29, 2020 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn - Medical Group Nephrology CurrentSince Jul 29, 2020 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Spruce St
Fl 5
Philadelphia, PA 19104
Phone (215) 662-2777

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

PO B0x 824320
Philadelphia, PA 19182

3400 Civic Center Blvd
#1S
Philadelphia, PA 19104
Phone (215) 615-3321

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 2

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": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601683200000",
    "number": "1366837759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "5 WHITE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "GHAZAL",
        "middle_name": "ZEKAVAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2020-10-03",
        "certification_date": "2020-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD470935",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT209174",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.