Individual provider Active NPI

Janine V. Kyrillos, M.D.

  • Internal Medicine Physician
  • Bala Cynwyd, PA
National Provider Identifier
1467487595
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-418857 Issued in PA
Practice address
225 E City Ave
Suite 109
Bala Cynwyd, PA 19004-1704
Phone
(610) 664-0134
Fax
(610) 664-2945
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD-418857 PA Primary

Addresses

Primary practice location

225 E City Ave
Suite 109
Bala Cynwyd, PA 19004-1704

Mailing address

225 E City Ave
Suite 109
Bala Cynwyd, PA 19004-1704
Phone (610) 664-0134

Other identifiers 2

IdentifierTypeStateIssuer
001906296MedicaidPA
8898201MedicaidNJ

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
I20031229000097 PA Practitioner - Internal Medicine 6406754670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

225 E City Ave
Suite 109
Bala Cynwyd, PA 19004-1724
Phone (215) 503-3838

2301 S Broad St
Philadelphia, PA 19148-3542

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-418857PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc Internal Medicine CurrentSince Oct 10, 2019 Accepting new patients
Jefferson University Physicians Internal Medicine CurrentSince Sep 3, 2002 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Oct 10, 2019 Accepting new patients

Locations

225 E City Line Ave
Ste 109
Bala Cynwyd, PA 19004
Phone (215) 503-3838

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

833 Chestnut St
Ste 701
Philadelphia, PA 19107
Phone (215) 955-0735

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

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 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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1467487595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E CITY AVE",
            "address_2": "SUITE 109",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041704",
            "telephone_number": "610-664-0134",
            "fax_number": "610-664-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CITY AVE",
            "address_2": "SUITE 109",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041704",
            "telephone_number": "610-664-0134",
            "fax_number": "610-664-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYRILLOS",
        "first_name": "JANINE",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD-418857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001906296",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8898201",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

Verify at the official NPI Registry.