NPIMap

Individual provider Active NPI

Mersedeh Rohanizadegan, MD

  • Clinical Genetics (M.D.) Physician
  • Philadelphia, PA
National Provider Identifier
1639433220
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
MD479123 Issued in PA
Practice address
3400 Civic Center Blvd.
1St FLR, Ste 300S
Philadelphia, PA 19104-4306
Phone
(215) 662-4710
Fax
(215) 614-0298
NPI assigned
Jun 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD479123 PA
Clinical Genetics (M.D.) Physician 207SG0201X MD479123 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd.
1St FLR, Ste 300S
Philadelphia, PA 19104-4306

Mailing address

3400 Spruce St Ste 5100
Philadelphia, PA 19104-4238
Phone (215) 662-4740

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230404001116 PA Practitioner - Medical Genetics and GenomicsPractitioner - Internal Medicine 6901154038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical Genetics and GenomicsAlso: Internal Medicine
Education
Other, 2010
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)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (267) 785-7100

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010
  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD479123PAMDClinical Genetics (M.D.) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Apr 1, 2025 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

3400 Civic Center Blvd
Fl 3
Philadelphia, PA 19104
Phone (215) 614-4100

3400 Convention Ave
Philadelphia, PA 19104
Phone (215) 662-2300

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

3400 Spruce St
Ste 5100
Philadelphia, PA 19104
Phone (215) 349-9360

Interoperability endpoints

  • Direct secure messaging: mersedeh.rohanizadegan@79171750068228.direct.elationemr.com
  • Direct secure messaging: rohanizadegan.mersedeh.dfci@direct.partners.masshiway.net

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 4

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1639433220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST STE 5100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD.",
            "address_2": "1ST FLR, STE 300S",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044306",
            "telephone_number": "215-662-4710",
            "fax_number": "215-614-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHANIZADEGAN",
        "first_name": "MERSEDEH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD479123",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "PA",
            "license": "MD479123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.