NPIMap

Individual provider Active NPI

Elizabeth Anne Genovese, M.D.

  • Vascular Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1609162999
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD452176 Issued in PA
Practice address
3400 Spruce St
4 Silverstein
Philadelphia, PA 19104-4206
Phone
(215) 615-4949
Fax
(215) 615-0828
NPI assigned
Jun 24, 2011
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X MD452176 PA Primary

Addresses

Primary practice location

3400 Spruce St
4 Silverstein
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce St
4 Silverstein
Philadelphia, PA 19104-4206
Phone (215) 615-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, PA2 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
I20180727001018 SC Practitioner - Vascular Surgery 8921304130 Reassigns benefits to 3 organizations
I20230126003412 PA Practitioner - Vascular Surgery 8921304130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 615-4949

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)71
Removal of tissue33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD452176PAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Mar 1, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Mar 1, 2023 Accepting new patients
Georgetown Memorial Hospital CurrentSince Oct 1, 2021 Accepting new patients
Waccamaw Community Hospital CurrentSince Oct 1, 2021 Accepting new patients
Georgetown Memorial Hospital CurrentSince Oct 1, 2021 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jul 12, 2018 Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

3400 Spruce St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-2050

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

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

1014 Huger Dr
Georgetown, SC 29440
Phone (843) 652-8390

606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000

4070 Highway 17
Murrells Inlt, SC 29576
Phone (843) 357-5100

Organizations & group practices 10

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 8

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": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1609162999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "4 SILVERSTEIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-615-4949",
            "fax_number": "215-615-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "4 SILVERSTEIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-615-4949",
            "fax_number": "215-615-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENOVESE",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD452176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.