Individual provider Active NPI

Ralph Robert Vassallo Jr., MD

  • Hematology (Internal Medicine) Physician
  • Philadelphia, PA
National Provider Identifier
1518291905
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
MD042201E Issued in PA
Practice address
700 Spring Garden St
Philadelphia, PA 19123-3508
Phone
(215) 451-4096
Fax
(215) 451-2500
NPI assigned
Oct 1, 2009
Last updated
Oct 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X MD042201E PA Primary

Addresses

Primary practice location

700 Spring Garden St
Philadelphia, PA 19123-3508

Mailing address

700 Spring Garden St
Philadelphia, PA 19123-3508
Phone (215) 451-4096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD042201EPAMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Red Cross PJ-Region Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1518291905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SPRING GARDEN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191233508",
            "telephone_number": "215-451-4096",
            "fax_number": "215-451-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SPRING GARDEN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191233508",
            "telephone_number": "215-451-4096",
            "fax_number": "215-451-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSALLO",
        "first_name": "RALPH",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-01",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "PA",
            "license": "MD042201E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.