Individual provider Active NPI

Kwasi Y Kwaadu, D.P.M

  • Podiatrist
  • Philadelphia, PA
National Provider Identifier
1396973152
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC006121 Issued in PA
Practice address
148 N 8TH Street
Philadelphia, PA 19107-2496
Phone
(215) 625-5341
Fax
(215) 629-0716
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC006121 PA Primary
Public Medicine Podiatrist 213EP0504X SC006121 PA
Primary Podiatric Medicine Podiatrist 213EP1101X SC006121 PA
Radiology Podiatrist 213ER0200X SC006121 PA
Sports Medicine Podiatrist 213ES0000X SC006121 PA
Foot & Ankle Surgery Podiatrist 213ES0103X SC006121 PA
Foot Surgery Podiatrist 213ES0131X SC006121 PA

Addresses

Primary practice location

148 N 8TH Street
Philadelphia, PA 19107-2496

Mailing address

148 N 8TH Street
Philadelphia, PA 19107-2496
Phone (215) 238-6600

Other identifiers 3

IdentifierTypeStateIssuer
102711775MedicaidPA
3884275000OtherPAIBX
9152882OtherPAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120808000055 PA Practitioner - Podiatry 7517113558 Reassigns benefits to 1 organization
I20251217003550 NY Practitioner - Podiatry 7517113558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

400 E Main St
Mount Kisco, NY 10549-3417
Phone (914) 666-1371

701 N Broadway
Sleepy Hollow, NY 10591-1020
Phone (914) 269-1914

755 N Broadway
Sleepy Hollow, NY 10591-1075
Phone (516) 734-8900

Hospital & facility affiliations

  • Northern Westchester Hospital Hospital, Mount Kisco, NY, CCN 330162
  • Phelps Hospital Hospital, Sleepy Hollow, NY, CCN 330261
  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC006121PAMDPodiatrist
007477NYMDDriving and Community Mobility Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Temple University of the Commonwealth System of Higher Education Podiatrist CurrentSince Oct 11, 2023 Accepting new patients
North Shore-Lij Medical PC CurrentSince Nov 16, 2025 Accepting new patients
Temple University of the Commonwealth System of Higher Education Past Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

755 N Broadway
Ste 230
Sleepy Hollow, NY 10591
Phone (914) 362-6278

3223 N Broad St
Ste 150
Philadelphia, PA 19140
Phone (215) 777-5713

148 N 8th St
Philadelphia, PA 19107
Phone (215) 238-6600

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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 11

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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1396973152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 N 8TH STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191072496",
            "telephone_number": "215-238-6600",
            "fax_number": "215-629-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 N 8TH STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191072496",
            "telephone_number": "215-625-5341",
            "fax_number": "215-629-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAADU",
        "first_name": "KWASI",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC006121",
            "primary": true
        },
        {
            "code": "213EP0504X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Public Medicine",
            "state": "PA",
            "license": "SC006121",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "PA",
            "license": "SC006121",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "PA",
            "license": "SC006121",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "PA",
            "license": "SC006121",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006121",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "SC006121",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102711775",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBX",
            "identifier": "3884275000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9152882",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.