NPIMap

Individual provider Active NPI

Fernando Alfonso Escobar Rengifo, MD

  • Pediatric Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1407087562
Registry record updated Jun 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
MD442271 Issued in PA
Practice address
3401 Civic Center Blvd
Chop Radiology
Philadelphia, PA 19104
Phone
(215) 590-1000
NPI assigned
Aug 6, 2009
Last updated
Jun 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X MD442271 PA Primary
Diagnostic Radiology Physician 2085R0202X MD442271 PA

Addresses

Primary practice location

3401 Civic Center Blvd
Chop Radiology
Philadelphia, PA 19104

Mailing address

3401 Civic Center Blvd
Chop Radiology
Philadelphia, PA 19104-5127
Phone (215) 590-1000

Other names 1

  • Fernando Alfonso Escobar Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110520000500 PA Practitioner - Diagnostic RadiologyPractitioner - Pediatric Medicine 0941486294 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Pediatric Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Children's Hospital, IncGroup PAC ID 0345154399, 40 clinicians

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (267) 425-9505

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD442271PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Services Inc CurrentSince Sep 17, 2012 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2017 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Pittsburgh Physicians Pediatric Radiology CurrentSince Jun 1, 2011 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Aug 11, 2018 Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Aug 11, 2018 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2017 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

3406 Peach St
Erie, PA 16508
Phone (814) 877-5381

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497312000000",
    "number": "1407087562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHOP RADIOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-590-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHOP RADIOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-590-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOBAR RENGIFO",
        "first_name": "FERNANDO",
        "middle_name": "ALFONSO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-06",
        "last_updated": "2017-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "PA",
            "license": "MD442271",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD442271",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FERNANDO",
            "last_name": "ESCOBAR",
            "middle_name": "ALFONSO",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.