NPIMap

Individual provider Active NPI

Julia Angela Elcock-Vengen, M.D.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1578575940
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD062119L Issued in PA
Practice address
1401 S 31St St
Philadelphia, PA 19146-3506
Phone
(215) 755-7700
Fax
(215) 755-3177
NPI assigned
Aug 13, 2006
Last updated
Apr 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD062119L PA Primary

Addresses

Primary practice location

1401 S 31St St
Philadelphia, PA 19146-3506

Mailing address

1401 S 31St St
2ND Floor
Philadelphia, PA 19146-3506
Phone (215) 925-2400

Other identifiers 1

IdentifierTypeStateIssuer
0017329470001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040129000438 PA Practitioner - Family Practice 0941103725 Reassigns benefits to 3 organizations
I20201130000059 DE Practitioner - Internal Medicine 0941103725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trinity Medical Associates, PAGroup PAC ID 8921252941, 13 clinicians

Practice addresses (Care Compare)

410 Foulk Rd
Suite 200B
Wilmington, DE 19803-3802
Phone (302) 762-6675

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Philadelphia Health Action Inc. CurrentSince Jan 4, 2016 Accepting new patients
Greater Philadelphia Health Action, Inc. CurrentSince Jan 4, 2016 Accepting new patients
Trinity Medical Associates PA CurrentSince Nov 1, 2020 Accepting new patients
Spuc, LLC CurrentSince Jun 1, 2015 Accepting new patients
Pennsylvania Urgent Care Centers, PLLC CurrentSince Jun 1, 2015 Accepting new patients
Dr. Joseph Schneider LLC Past Accepting new patients
Jennersville Family Medicine LLC Family Medicine Past Accepting new patients
Springfield Family Chiropractic, P.C. PastSince Oct 29, 2011 Accepting new patients

Locations

410 Foulk Rd
Ste 200B
Wilmington, DE 19803
Phone (302) 561-4202

150 E Pennsylvania Ave
Ste 140
Downingtown, PA 19335
Phone (610) 518-1060

934 Montgomery Ave
Penn Valley, PA 19072
Phone (484) 270-8600

1401 S 31st St
Philadelphia, PA 19146
Phone (215) 755-7700

1401 S 31st St
#2
Philadelphia, PA 19146

1444 W Passyunk Ave
Philadelphia, PA 19145
Phone (215) 389-4444

432 N 6th St
Philadelphia, PA 19123
Phone (215) 627-8000

5501 Woodland Ave
Philadelphia, PA 19143
Phone (215) 724-4700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17876/brand/1/csg/1/fhir/r4
  • Direct secure messaging: julia.elcock-vengen.1@17876.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 7

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1578575940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S 31ST ST",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463506",
            "telephone_number": "215-925-2400",
            "fax_number": "215-925-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S 31ST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463506",
            "telephone_number": "215-755-7700",
            "fax_number": "215-755-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELCOCK-VENGEN",
        "first_name": "JULIA",
        "middle_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD062119L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017329470001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.