Individual provider Active NPI

Michael S Nalbantian, MD

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1578520243
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD031713L Issued in PA
Practice address
9601 Bustleton Ave
Philadelphia, PA 19115
Phone
(215) 676-5100
Fax
(215) 676-4122
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD031713L PA Primary

Addresses

Primary practice location

9601 Bustleton Ave
Philadelphia, PA 19115

Mailing address

9601 Bustleton Ave
Philadelphia, PA 19115
Phone (215) 676-5100

Other identifiers 1

IdentifierTypeStateIssuer
0009230960009MedicaidPA

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1578520243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19115",
            "telephone_number": "215-676-5100",
            "fax_number": "215-676-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19115",
            "telephone_number": "215-676-5100",
            "fax_number": "215-676-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALBANTIAN",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD031713L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009230960009",
            "state": "PA"
        }
    ],
    "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 Sep 11, 2013; 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.