Individual provider Active NPI

John Michael Vasudevan, MD

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
National Provider Identifier
1578733226
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD445550 Issued in PA
Practice address
3400 Spruce Street/5 West Gates
Department of Physical Medicine & Rehabilitation
Philadelphia, PA 19104
Phone
(215) 662-8928
NPI assigned
Mar 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X MD445550 PA
Physical Medicine & Rehabilitation Physician 208100000X MD445550 PA Primary

Addresses

Primary practice location

3400 Spruce Street/5 West Gates
Department of Physical Medicine & Rehabilitation
Philadelphia, PA 19104

Mailing address

3400 Spruce Street/5 West Gates
Department of Physical Medicine & Rehabilitation
Philadelphia, PA 19104
Phone (215) 662-8928

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120905000099 PA Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 9931356524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Sports Medicine
Education
University of Wisconsin School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

800 Spruce St
Philadelphia, PA 19107-6130
Phone (215) 662-3340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Apr 1, 2015 Accepting new patients
University of Penn-Medical Group Physical Medicine & Rehabilitation CurrentSince Apr 1, 2015 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

1800 Lombard St
Fl 1
Philadelphia, PA 19146
Phone (215) 893-2600

235 S 33rd St
Philadelphia, PA 19104
Phone (215) 615-4400

1800 Lombard St
Philadelphia, PA 19146
Phone (215) 545-4173

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Spruce St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-3005

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

145 King of Prussia Rd
Ste 305
Radnor, PA 19087
Phone (610) 902-5700

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1578733226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET/5 WEST GATES",
            "address_2": "DEPARTMENT OF PHYSICAL MEDICINE & REHABILITATION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-8928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET/5 WEST GATES",
            "address_2": "DEPARTMENT OF PHYSICAL MEDICINE & REHABILITATION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-8928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASUDEVAN",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-10",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "PA",
            "license": "MD445550",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD445550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.