Individual provider Active NPI

Constance J Dine, MD

  • Pulmonary Disease Physician
  • Philadelphia, PA
National Provider Identifier
1417010026
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD425693 Issued in PA
Practice address
3400 Civic Center Boulevard
West Pavilion-1St Floor
Philadelphia, PA 19104-4306
Phone
(215) 662-3202
Fax
(215) 349-8432
NPI assigned
Dec 18, 2006
Last updated
Aug 14, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD425693 PA Primary

Addresses

Primary practice location

3400 Civic Center Boulevard
West Pavilion-1St Floor
Philadelphia, PA 19104-4306

Mailing address

3400 Civic Center Boulevard
West Pavilion-1St Floor
Philadelphia, PA 19104-4306
Phone (215) 662-3202

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
I20050712000811 PA Practitioner - Internal Medicine 1052347937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3624 Market St
FL 2
Philadelphia, PA 19104-5803
Phone (215) 662-7772

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD425693PAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Pulmonary Disease CurrentSince Jul 1, 2008 Accepting new patients
University of Penn - Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2008 Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Bih Radiologic Foundation Inc Past Accepting new patients

Locations

1800 Lombard St
Fl 1
Philadelphia, PA 19146
Phone (215) 893-2600

3400 Civic Center Blvd
#1W
Philadelphia, PA 19104
Phone (215) 662-6260

3400 Civic Center Blvd
Fl 1
Philadelphia, PA 19104
Phone (215) 615-5864

3400 Civic Center Blvd
Fl 1W
Philadelphia, PA 19104

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3737 Market St
Fl 10
Philadelphia, PA 19104
Phone (215) 301-0368

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

Organizations & group practices 5

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 3

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1417010026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BOULEVARD",
            "address_2": "WEST PAVILION-1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044306",
            "telephone_number": "215-662-3202",
            "fax_number": "215-379-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BOULEVARD",
            "address_2": "WEST PAVILION-1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044306",
            "telephone_number": "215-662-3202",
            "fax_number": "215-349-8432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINE",
        "first_name": "CONSTANCE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD425693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.