Individual provider Active NPI

Michael Anthony Dellavecchia, MD, PHD, FACS

  • Ophthalmology Physician
  • Bryn Mawr, PA
National Provider Identifier
1437172277
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD020408E Issued in PA
Practice address
875 County Line Rd
Bryn Mawr Med BLDG North Suite 204
Bryn Mawr, PA 19010-3143
Phone
(610) 527-3406
Fax
(610) 527-3406
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD020408E PA Primary

Addresses

Primary practice location

875 County Line Rd
Bryn Mawr Med BLDG North Suite 204
Bryn Mawr, PA 19010-3143

Mailing address

846 Farragut Rd
Berwyn, PA 19312-2005
Phone (610) 640-1578

Other practice location 1

840 Walnut St Ste 1240
Philadelphia, PA 19107-5109
Phone (215) 928-3138

Other practice location 2

9880 Bustleton Ave Ste 313
Philadelphia, PA 19115-2144
Phone (215) 677-9762

Other practice location 3

1330 Powell St Ste 502
Norristown, PA 19401-3353
Phone (610) 272-6888

Other practice location 4

500 York Rd Ste 102
Jenkintown, PA 19046-2871
Phone (215) 885-6830

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
I20070413000341 PA Practitioner - Ophthalmology 6406951847 Reassigns benefits to 2 organizations
Practice locations: Bryn Mawr, PA

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Temple University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Accuvision Eye MD Caregroup, PCGroup PAC ID 0244215648, 5 clinicians
Northern Ophthalmic AssociatesGroup PAC ID 8628054988, 9 clinicians

Practice addresses (Care Compare)

100 Church Rd
Ardmore, PA 19003-2316
Phone (610) 649-7616

500 Old York Rd
Jenkintown, PA 19046-2852

500 York Rd
Suite 102
Jenkintown, PA 19046-2890

913 Walnut St
FL 2
Philadelphia, PA 19107-5190
Phone (215) 627-1515

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.24 of 100Reported as group
Quality
100
Improvement activities
40
Cost
44.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD020408EPAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ophthalmic Associates Ophthalmology CurrentSince Nov 1, 2014 Accepting new patients
Northern Ophthalmic Associates Ophthalmology CurrentSince Nov 1, 2014 Accepting new patients
Accuvision Eye MD Caregroup, PC Ophthalmology CurrentSince Mar 1, 2016 Accepting new patients
David S C Pao MD PC Ophthalmology Past Accepting new patients

Locations

225 Sunset Rd
Willingboro, NJ 08046
Phone (609) 877-2800

100 Church Rd
Ste 100
Ardmore, PA 19003
Phone (610) 649-7616

1330 Powell St
Ste 502
Norristown, PA 19401
Phone (610) 272-6888

840 Walnut St
Ste 1240
Philadelphia, PA 19107
Phone (215) 836-1290

9880 Bustleton Ave
Ste 313
Philadelphia, PA 19115
Phone (215) 677-9762

913 Walnut St
Fl 2
Philadelphia, PA 19107
Phone (215) 627-1515

500 York Rd
Ste 102
Rydal, PA 19046
Phone (215) 885-6830

Interoperability endpoints

  • Direct secure messaging: michael.dellavecchiamd.p1@direct.cdestefano.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1437172277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "846 FARRAGUT RD",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193122005",
            "telephone_number": "610-640-1578",
            "fax_number": "610-640-1578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 COUNTY LINE RD",
            "address_2": "BRYN MAWR MED BLDG NORTH SUITE 204",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103143",
            "telephone_number": "610-527-3406",
            "fax_number": "610-527-3406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 Walnut St Ste 1240",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075109",
            "country_code": "US",
            "telephone_number": "215-928-3138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9880 Bustleton Ave Ste 313",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191152144",
            "country_code": "US",
            "telephone_number": "215-677-9762",
            "fax_number": "215-677-6790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1330 Powell St Ste 502",
            "address_purpose": "LOCATION",
            "city": "Norristown",
            "state": "PA",
            "postal_code": "194013353",
            "country_code": "US",
            "telephone_number": "610-272-6888",
            "fax_number": "610-272-6909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 York Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Jenkintown",
            "state": "PA",
            "postal_code": "190462871",
            "country_code": "US",
            "telephone_number": "215-885-6830",
            "fax_number": "215-885-2433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELLAVECCHIA",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Prof.",
        "credential": "MD, PHD, FACS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD020408E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.