Individual provider Active NPI

Frances Sirico-Kelly, D.O.

  • Internal Medicine Physician
  • Wyndmoor, PA
National Provider Identifier
1477547610
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS006540-L Issued in PA
Practice address
805 E Willow Grove Ave
Wyndmoor, PA 19038-7968
Phone
(215) 233-0557
Fax
(215) 233-0381
NPI assigned
Sep 2, 2005
Sex
Female
Sole proprietor
Yes

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.

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20081018000014 PA Practitioner - Internal Medicine 3779641881 Reassigns benefits to 1 organization
Practice locations: Abington, PA; Flourtown, PA; Philadelphia, PA; Wyndmoor, PA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS006540-LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physician Inc. Internal Medicine CurrentSince Jan 1, 2018 Accepting new patients
Temple Physicians Inc Internal Medicine CurrentSince Jan 1, 2018 Accepting new patients
Temple Physicians Inc Internal Medicine Current Accepting new patients
Alexander Foot Care PastSince Aug 1, 2014 Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

8200 Flourtown Ave
Ste 6
Wyndmoor, PA 19038
Phone (215) 233-1555

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS006540-L PA Primary

Addresses

NPPES NPI Registry

Primary practice location

805 E Willow Grove Ave
Wyndmoor, PA 19038-7968

Mailing address

805 E Willow Grove Ave
Wyndmoor, PA 19038-7968
Phone (215) 233-0557

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
01671144MedicaidPA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 28, 2009.

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261958400000",
    "number": "1477547610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E WILLOW GROVE AVE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190387968",
            "telephone_number": "215-233-0557",
            "fax_number": "215-233-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E WILLOW GROVE AVE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190387968",
            "telephone_number": "215-233-0557",
            "fax_number": "215-233-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRICO-KELLY",
        "first_name": "FRANCES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2009-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS006540-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01671144",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyndmoor, PA

Sources for this page

Verify at the official NPI Registry.