Individual provider Active NPI

Thomas Samuel Albanesi III, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1407416167
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT217739 Issued in PA
Practice address
1233 Locust St
Philadelphia, PA 19107-5453
Phone
(215) 790-1788
NPI assigned
Jun 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT217739 PA Primary

Addresses

Primary practice location

1233 Locust St
Philadelphia, PA 19107-5453

Mailing address

825 N 2ND St FL 2
Philadelphia, PA 19123-3009
Phone (412) 848-8796

Other practice location 1

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-2000

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
I20241125003741 PA Practitioner - Internal Medicine 7719212851 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Philadelphia Fight Internal Medicine Current Accepting new patients
Philadelphia Fight CurrentSince Sep 16, 2024 Accepting new patients

Locations

1233 Locust St
Philadelphia, PA 19107
Phone (215) 790-1788

1233 Locust St
Ste 500
Philadelphia, PA 19107
Phone (215) 790-1788

1233 Locust St
Fl 3
Philadelphia, PA 19107
Phone (267) 725-0252

1233 Locust St
Fl 5
Philadelphia, PA 19107
Phone (215) 790-1788

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1407416167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N 2ND ST FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191233009",
            "telephone_number": "412-848-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075453",
            "telephone_number": "215-790-1788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405103",
            "country_code": "US",
            "telephone_number": "215-707-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALBANESI",
        "first_name": "THOMAS",
        "middle_name": "SAMUEL",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-15",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT217739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.