NPIMap

Individual provider Active NPI

Philip Nimoityn, MD

  • Cardiovascular Disease Physician
  • Philadelphia, PA
National Provider Identifier
1497864375
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD019676E Issued in PA
Practice address
1015 Chestnut St Ste 512
Philadelphia, PA 19107-4305
Phone
(267) 479-4180
Fax
(215) 873-0201
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD019676E PA Primary

Addresses

Primary practice location

1015 Chestnut St Ste 512
Philadelphia, PA 19107-4305

Mailing address

207 N Broad St FL 3
Philadelphia, PA 19107-1500
Phone (267) 479-4180

Other identifiers 1

IdentifierTypeStateIssuer
0008130200005MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040708000632 PA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2769469451 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Methodist Associates in Healthcare, IncGroup PAC ID 6406755651, 387 clinicians
Cardiology Consultants of Philadelphia PCGroup PAC ID 5294620746, 154 clinicians

Practice addresses (Care Compare)

111 S 11TH St
Suite 8490
Philadelphia, PA 19107-4824
Phone (215) 955-6161

1703 S Broad St
Suite 300
Philadelphia, PA 19148-1536
Phone (215) 463-5333

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • St Mary Medical Center Hospital, Langhorne, PA, CCN 390258

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD019676EPAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc Cardiovascular Disease CurrentSince Oct 14, 2018 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Oct 14, 2018 Accepting new patients
Cardiology Consultants of Philadelphia, P.C. Cardiovascular Disease CurrentSince Aug 1, 2018 Accepting new patients
Methodist Associates in Healthcare, Inc Current Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

3300 Tillman Dr
Bldg B
Bensalem, PA 19020

1015 Chestnut St
Ste 512
Philadelphia, PA 19107
Phone (267) 479-4180

207 N Broad St
Fl 3
Philadelphia, PA 19107
Phone (215) 361-5020

111 S 11th St
Ste 8490
Philadelphia, PA 19107
Phone (215) 955-6161

1703 S Broad St
Ste 300
Philadelphia, PA 19148
Phone (215) 462-7100

Organizations & group practices 5

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 5

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1497864375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BROAD ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071500",
            "telephone_number": "267-479-4180",
            "fax_number": "215-873-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 CHESTNUT ST STE 512",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074305",
            "telephone_number": "267-479-4180",
            "fax_number": "215-873-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMOITYN",
        "first_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD019676E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008130200005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.