Individual provider Active NPI

Roger M. Wint, M.D.

  • Cardiovascular Disease Physician
  • Philadelphia, PA
National Provider Identifier
1639172562
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD024876E Issued in PA
Practice address
9501 Roosevelt Blvd
Ste 501
Philadelphia, PA 19114-1030
Phone
(215) 673-5000
Fax
(215) 673-0718
NPI assigned
May 24, 2005
Last updated
Sep 7, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD024876E PA Primary

Addresses

Primary practice location

9501 Roosevelt Blvd
Ste 501
Philadelphia, PA 19114-1030

Mailing address

9501 Roosevelt Blvd
Ste 305
Philadelphia, PA 19114-1028
Phone (215) 671-4280

Other identifiers 1

IdentifierTypeStateIssuer
0010504640005MedicaidPA

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
I20201229000707 PA Order and Referring Only - Cardiovascular Disease (Cardiology)Practitioner - Cardiovascular Disease (Cardiology) 6406843846

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD024876EPAMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1639172562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 ROOSEVELT BLVD",
            "address_2": "STE 305",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141028",
            "telephone_number": "215-671-4280",
            "fax_number": "215-464-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 ROOSEVELT BLVD",
            "address_2": "STE 501",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141030",
            "telephone_number": "215-673-5000",
            "fax_number": "215-673-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINT",
        "first_name": "ROGER",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD024876E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010504640005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.