Active NPI
Elizabeth Dianne Pulte, MD
- Hematology (Internal Medicine) Physician
- Philadelphia, PA
National Provider Identifier
1417040528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology (Internal Medicine) Physician
- License
- MD442950
- Practice address
- 1015 Chestnut St
Suite 1321
Philadelphia, PA 19107-4310 - Phone
- (215) 955-4730
- Fax
- (215) 503-9188
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD442950 | PA | |
| Hematology (Internal Medicine) Physician | 207RH0000X | MD442950 | PA | Primary |
| Hematology & Oncology Physician | 207RH0003X | 213816 | NY | |
| Medical Oncology Physician | 207RX0202X | MD442950 | PA |
Addresses
Primary practice location
1015 Chestnut St
Suite 1321
Philadelphia, PA 19107-4310
Mailing address
1015 Chestnut St
Suite 1321
Philadelphia, PA 19107-4310
Phone (215) 955-4730
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102613907 | Medicaid | PA | |
| 0193054 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213816 | NY | MD | Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362441600000",
"number": "1417040528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 CHESTNUT ST",
"address_2": "SUITE 1321",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074310",
"telephone_number": "215-955-4730",
"fax_number": "215-503-9188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 CHESTNUT ST",
"address_2": "SUITE 1321",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074310",
"telephone_number": "215-955-4730",
"fax_number": "215-503-9188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PULTE",
"first_name": "ELIZABETH",
"middle_name": "DIANNE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2013-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD442950",
"primary": false
},
{
"code": "207RH0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology",
"state": "PA",
"license": "MD442950",
"primary": true
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "NY",
"license": "213816",
"primary": false
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "PA",
"license": "MD442950",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102613907",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0193054",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.