Individual provider Active NPI

Christine Tucker, M.D.

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1376877969
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD446321 Issued in PA
Practice address
3401 Civic Center Blvd
Children'S Hospital of Philadelphia - General Peds
Philadelphia, PA 19104-4319
Phone
(215) 590-2164
Fax
(215) 590-2180
NPI assigned
Sep 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Hospital 282NC2000X MT195277 PA
Pediatrics Physician 208000000X MD446321 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Children'S Hospital of Philadelphia - General Peds
Philadelphia, PA 19104-4319

Mailing address

100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9232

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
I20120820000964 PA Practitioner - Pediatric Medicine 1254588676 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD446321PAMDPediatrics Physician
MT195277PAMDChildren's Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Pediatrics CurrentSince Jul 20, 2012 Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Jul 20, 2012 Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Hospital of Philadelphia Children Past Accepting new patients

Locations

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1376877969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9232",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA - GENERAL PEDS",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-2164",
            "fax_number": "215-590-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CHRISTINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "PA",
            "license": "MT195277",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD446321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.