Individual provider Active NPI

Bianca Costa Kapoor-Heaphy, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Philadelphia, PA
National Provider Identifier
1639737711
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
MT218051 Issued in PA
Practice address
3401 Civic Center Blvd
Division of Child Neurology
Philadelphia, PA 19104-4399
Phone
(215) 590-1719
NPI assigned
Jun 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT218051 PA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X MT218051 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Division of Child Neurology
Philadelphia, PA 19104-4399

Mailing address

3401 Civic Center Blvd
Division of Child Neurology
Philadelphia, PA 19104-4319
Phone (215) 590-1719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241111002548 NJ Practitioner - Neurology 1850825043 Reassigns benefits to 1 organization
I20241111002837 PA Practitioner - Neurology 1850825043 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT218051PAMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childen'S Health Care Associates Inc. CurrentSince Nov 1, 2024 Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Nov 1, 2024 Accepting new patients
Childrens Health Care Associates of New Jersey PC Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc Pediatrics CurrentSince Nov 1, 2024 Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients

Locations

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

3401 Civic Center Blvd
Rm 55
Philadelphia, PA 19104
Phone (215) 510-1220

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

2929 Arch St
Fl 12
Philadelphia, PA 19104

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1639737711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF CHILD NEUROLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF CHILD NEUROLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044399",
            "telephone_number": "215-590-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPOOR-HEAPHY",
        "first_name": "BIANCA",
        "middle_name": "COSTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT218051",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "PA",
            "license": "MT218051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.