NPIMap

Individual provider Active NPI

Manju Ambelil, M.D.

  • Anatomic Pathology Physician
  • Philadelphia, PA
National Provider Identifier
1427478205
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
MD463295 Issued in PA
Practice address
333 Cottman Ave
Philadelphia, PA 19111-2434
Phone
(215) 728-3675
NPI assigned
Apr 21, 2014
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X MD463295 PA Primary

Addresses

Primary practice location

333 Cottman Ave
Philadelphia, PA 19111-2434

Mailing address

3509 N Broad St
Philadelphia, PA 19140-4105
Phone (215) 707-3911

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
I20190731000617 PA Practitioner - Pathology 7012251648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

333 Cottman Ave
Philadelphia, PA 19111-2434
Phone (215) 707-2111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD463295PAMDClinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Jul 13, 2025 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Jul 13, 2025 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Main Line Gastroenterology Associates, PC Past Accepting new patients

Locations

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3500 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3656

Organizations & group practices 4

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1427478205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105",
            "telephone_number": "215-707-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112434",
            "telephone_number": "215-728-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBELIL",
        "first_name": "MANJU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "PA",
            "license": "MD463295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.