Individual provider Active NPI

Monica Rezk, D.O.

  • Adolescent Medicine (Family Medicine) Physician
  • Radnor, PA
National Provider Identifier
1467849281
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
License
OS020797 Issued in PA
Practice address
250 King of Prussia Rd Ste 2J
Radnor, PA 19087-5227
Phone
(610) 902-2450
Fax
(610) 902-2466
NPI assigned
Apr 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) Physician 207QA0000X OS020797 PA Primary

Addresses

Primary practice location

250 King of Prussia Rd Ste 2J
Radnor, PA 19087-5227

Mailing address

250 King of Prussia Rd Ste 2J
Radnor, PA 19087-5227
Phone (610) 902-2450

Other practice location 1

2157 Main St
Buffalo, NY 14214-2648
Phone (716) 862-1840

Other practice location 2

3100 SW 62nd Ave
Miami, FL 33155
Phone (786) 624-2891

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
I20200903002872 PA Practitioner - Family Practice 2466879564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

145 King of Prussia Rd 301
Adolescentand Yng Adult Med
Radnor, PA 19087-4557
Phone (610) 902-2450

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS020797PAMDAdolescent Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Aug 27, 2020 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Adolescent Medicine Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Aug 27, 2020 Accepting new patients

Locations

250 King of Prussia Rd
Ste 2J
Radnor, PA 19087
Phone (610) 902-2450

145 King of Prussia Rd
Ste 301
Wayne, PA 19087
Phone (610) 902-2450

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

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.

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1467849281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 KING OF PRUSSIA RD STE 2J",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875227",
            "telephone_number": "610-902-2450",
            "fax_number": "610-902-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 KING OF PRUSSIA RD STE 2J",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875227",
            "telephone_number": "610-902-2450",
            "fax_number": "610-902-2466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2157 Main St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142142648",
            "country_code": "US",
            "telephone_number": "716-862-1840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3100 SW 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "33155",
            "country_code": "US",
            "telephone_number": "786-624-2891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZK",
        "first_name": "MONICA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "PA",
            "license": "OS020797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Radnor, PA

Sources for this page

Verify at the official NPI Registry.