Active NPI
Uchechukwu Madtha, DO
- Psychiatry Physician
- Philadelphia, PA
National Provider Identifier
1487181780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- OT017954
- Practice address
- 3400 Spruce St
Philadelphia, PA 19104-4238 - Phone
- (215) 316-5151
- NPI assigned
- May 17, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | OT017954 | PA | Primary |
Addresses
Primary practice location
3400 Spruce St
Philadelphia, PA 19104-4238
Mailing address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone (202) 577-1095
Other practice location 1
4641 Roosevelt Blvd
Philadelphia, PA 19124-2343
Phone (202) 577-1095
Other practice location 2
230 N Broad St
Philadelphia, PA 19102-1121
Phone (202) 577-1095
Other practice location 3
3401 N Broad St
Philadelphia, PA 19140-5189
Phone (215) 707-2000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | PHILADELPHIA | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619654400000",
"number": "1487181780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405103",
"telephone_number": "202-577-1095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044238",
"telephone_number": "215-316-5151"
}
],
"practiceLocations": [
{
"address_1": "4641 Roosevelt Blvd",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191242343",
"country_code": "US",
"telephone_number": "202-577-1095",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "230 N Broad St",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191021121",
"country_code": "US",
"telephone_number": "202-577-1095",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3401 N Broad St",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191405189",
"country_code": "US",
"telephone_number": "215-707-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MADTHA",
"first_name": "UCHECHUKWU",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-17",
"last_updated": "2021-04-29",
"certification_date": "2021-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "OT017954",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "PHILADELPHIA",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "3400 Spruce St",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191044238",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.