Individual provider Active NPI

Thomas Dalfonso Jr.

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1538020409
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1 Convention Ave
Philadelphia, PA 19104-4311
Phone
(215) 662-4000
NPI assigned
Nov 20, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

1 Convention Ave
Philadelphia, PA 19104-4311

Mailing address

1 Convention Ave
Philadelphia, PA 19104-4311
Phone (215) 662-4000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260113003675 PA Practitioner - Physician Assistant 4981180544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4226

PO Box
Philadelphia, PA 19182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince Jan 26, 2026 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 26, 2026 Accepting new patients

Locations

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1763596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1538020409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CONVENTION AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044311",
            "telephone_number": "215-662-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CONVENTION AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044311",
            "telephone_number": "215-662-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALFONSO",
        "first_name": "THOMAS",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-20",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.