Individual provider Active NPI

Doris E Tirado, M.D.

  • Obstetrics & Gynecology Physician
  • Media, PA
National Provider Identifier
1386655512
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD054294L Issued in PA
Practice address
1098 W Baltimore Pike
Suite 3106 Riddle HLTH Ctr 3
Media, PA 19063-5139
Phone
(610) 891-6240
Fax
(610) 891-6244
NPI assigned
Aug 11, 2006
Last updated
Dec 31, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD054294L PA Primary

Addresses

Primary practice location

1098 W Baltimore Pike
Suite 3106 Riddle HLTH Ctr 3
Media, PA 19063-5139

Mailing address

1098 W Baltimore Pike
Suite 3106 Riddle HLTH Ctr 3
Media, PA 19063-5139
Phone (610) 891-6240

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
I20080714000231 PA Practitioner - Obstetrics/Gynecology 0749353431 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD054294LPAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Obstetrics & Gynecology CurrentSince Jul 1, 2008 Accepting new patients
Main Line Healthcare Past Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1020 Baltimore Pike
Ste 310
Glen Mills, PA 19342
Phone (484) 227-7532

1098 W Baltimore Pike
Ste 3106
Media, PA 19063
Phone (610) 891-6240

1601 McDaniel Dr
Ste 50
West Chester, PA 19380
Phone (484) 905-8000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1386655512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1098 W BALTIMORE PIKE",
            "address_2": "SUITE 3106 RIDDLE HLTH CTR 3",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635139",
            "telephone_number": "610-891-6240",
            "fax_number": "610-891-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 W BALTIMORE PIKE",
            "address_2": "SUITE 3106 RIDDLE HLTH CTR 3",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635139",
            "telephone_number": "610-891-6240",
            "fax_number": "610-891-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRADO",
        "first_name": "DORIS",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD054294L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.