Elisa Vengalil, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD485699 Issued in PA

Practice address

2230 Cottman Ave
Philadelphia, PA 19149-1230

Phone

(215) 685-6769

NPI assigned

Apr 1, 2021

Last updated

Jun 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• City of Philadelphia

  dba Health Care Center 2

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1942317094
  Medicare reassignment NPD
• City of Philadelphia

  dba Strawberry Mansion Health Center

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1417064353
  NPD
• City of Philadelphia

  dba Phila Health Dept Laboratory

  • Clinical Medical Laboratory
  • Phila, PA
  • NPI 1689688798
  NPD

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1518545227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491230",
            "telephone_number": "215-685-6769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENGALIL",
        "first_name": "ELISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD485699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert John Vender, MD
• Michael A. Venditto, DO
• Cynthia Rodas Venegas, M.D.
• Kimberly Venella
• Francis Veneziale Jr.
• Fabian A Vengoechea, M.D.
• Mariya Vengrenyuk, M.D.
• Tejaswi Venigalla, MD
• Jonathon Venitz, LSW
• Chantel Marie Venkataraman, MD

• Pediatrics Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.

Verify at the official NPI Registry.