Individual provider Active NPI

Terri Tuckman, M.D.

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1457377293
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD044094E Issued in PA
Practice address
111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824
Phone
(215) 955-2900
Fax
(215) 923-1562
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD044094E PA Primary

Addresses

Primary practice location

111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824

Mailing address

111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824
Phone (215) 955-2900

Other identifiers 2

IdentifierTypeStateIssuer
6595006MedicaidNJ
001214834MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040311000773 PA Practitioner - Diagnostic Radiology 5092604769 Reassigns benefits to 2 organizations
I20201124000562 NJ Practitioner - Diagnostic Radiology 5092604769 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Perelman School of Med at the University of Pennsylvania, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University Radiology Associates LLCGroup PAC ID 7315845708, shared by 3 NPIs, 110 clinicians
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

1 W Germantown Pike
East Norriton, PA 19401-1513
Phone (610) 277-3202

111 S 11TH St
3Rd FLR Suite 3390
Philadelphia, PA 19107-5098
Phone (800) 858-1662

3 Crescent Dr
Suite 1002
Philadelphia, PA 19112-1016
Phone (215) 503-4900

534 2ND Ave
Suite 102
Collegeville, PA 19426-2654
Phone (610) 831-0500

650 Carnegie Blvd
Suite 240
Malvern, PA 19355-8519
Phone (215) 503-4900

850 Walnut St
Philadelphia, PA 19107-5109

999 Route 73 N 101
Jefferson Outpatient Imaging
Marlton, NJ 08053-1227
Phone (856) 424-2929

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Aug 26, 2020 Accepting new patients
Jefferson University Radiology Associates LLC Diagnostic Radiology Current Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Apr 18, 2010 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology Current Accepting new patients
Jefferson University Physicians Diagnostic Radiology CurrentSince May 3, 1990 Accepting new patients
Jefferson University Physicians of New Jersey, P.C. CurrentSince Sep 1, 2020 Accepting new patients
Imaging Professionals of Pennsylvania PC Diagnostic Radiology Past Accepting new patients
Jefferson University Physicians Diagnostic Radiology Past Accepting new patients

Locations

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

999 Route 73 N
Ste 101
Marlton, NJ 08053
Phone (856) 424-2929

243 Hurffville Crosskeys Rd
Sewell, NJ 08080
Phone (609) 680-9263

443 Laurel Oak Rd
Ste 130
Voorhees, NJ 08043
Phone (856) 741-0122

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

850 Walnut St
Philadelphia, PA 19107
Phone (215) 503-4900

111 S 11th St
Ste G5390
Philadelphia, PA 19107
Phone (215) 955-7832

111 S 11th St
Ste 3390
Philadelphia, PA 19107
Phone (215) 955-2900

111 S 11th St
Ste G3390
Philadelphia, PA 19107
Phone (215) 955-2900

111 S 11th St
Fl 3
William Penn Annex West, PA 19107
Phone (215) 955-4804

Organizations & group practices 8

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1457377293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-2900",
            "fax_number": "215-923-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-2900",
            "fax_number": "215-923-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKMAN",
        "first_name": "TERRI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD044094E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6595006",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001214834",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.