Individual provider Active NPI

Madeline Reganis, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Philadelphia, PA
National Provider Identifier
1427619790
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
OT019425 Issued in PA
Practice address
117 S. 11TH Street
204 Pavilion
Philadelphia, PA 19107-4949
Phone
(215) 503-3876
NPI assigned
Jun 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X OT019425 PA Primary

Addresses

Primary practice location

117 S. 11TH Street
204 Pavilion
Philadelphia, PA 19107-4949

Mailing address

117 S. 11TH Street
204 Pavilion
Philadelphia, PA 19107-4949
Phone (215) 503-3876

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
I20240625004391 PA Practitioner - Pathology 3476097981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Department of Pathology and Lab Medicine
Philadelphia, PA 19104-4206
Phone (215) 662-6503

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT019425PAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Jul 15, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 15, 2024 Accepting new patients

Locations

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

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1427619790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S. 11TH STREET",
            "address_2": "204 PAVILION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074949",
            "telephone_number": "215-503-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S. 11TH STREET",
            "address_2": "204 PAVILION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074949",
            "telephone_number": "215-503-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGANIS",
        "first_name": "MADELINE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "OT019425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.