Individual provider Active NPI

Michael Benjamin Dratch, MD

  • Cardiovascular Disease Physician
  • Elkins Park, PA
National Provider Identifier
1417046533
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD010130E Issued in PA
Practice address
401 Township Line Rd
Suite a
Elkins Park, PA 19027-2202
Phone
(215) 663-1188
Fax
(215) 663-9152
NPI assigned
Oct 12, 2006
Last updated
Oct 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD010130E PA Primary

Addresses

Primary practice location

401 Township Line Rd
Suite a
Elkins Park, PA 19027-2202

Mailing address

401 Township Line Rd
Suite a
Elkins Park, PA 19027-2202
Phone (215) 663-1188

Other identifiers 1

IdentifierTypeStateIssuer
0006411870003MedicaidPA

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

LicenseStateTypeSpecialty
MD010130EPAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Associates, Inc Cardiovascular Disease Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1417046533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 TOWNSHIP LINE RD",
            "address_2": "SUITE A",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272202",
            "telephone_number": "215-663-1188",
            "fax_number": "215-663-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 TOWNSHIP LINE RD",
            "address_2": "SUITE A",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272202",
            "telephone_number": "215-663-1188",
            "fax_number": "215-663-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRATCH",
        "first_name": "MICHAEL",
        "middle_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD010130E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006411870003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.