NPIMap

Individual provider Active NPI

Andreas Ujdud Wali, M.D.

  • Interventional Cardiology Physician
  • Camp Hill, PA
National Provider Identifier
1649273764
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD068378L Issued in PA
Practice address
875 Poplar Church Rd
Suite 400
Camp Hill, PA 17011-2203
Phone
(717) 724-6450
Fax
(717) 724-6451
NPI assigned
May 23, 2005
Last updated
Aug 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD068378L PA
Interventional Cardiology Physician 207RI0011X MD068378L PA Primary

Addresses

Primary practice location

875 Poplar Church Rd
Suite 400
Camp Hill, PA 17011-2203

Mailing address

100 N Academy Ave
Danville, PA 17822-9800
Phone (717) 724-6450

Other identifiers 2

IdentifierTypeStateIssuer
0017687160001MedicaidPA
060054509OtherRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awali122107@direct.geisinger.edu Direct

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
I20060601000127 PA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 4688641871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

875 Poplar Church Rd
Suite 400
Camp Hill, PA 17011-2203
Phone (717) 724-6450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting36
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2022 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
Penn State Health Medical Group, LLC Past Accepting new patients

Locations

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

875 Poplar Church Rd
Ste 400
Camp Hill, PA 17011
Phone (717) 975-0900

1211 Forge Rd
Ste 200
Carlisle, PA 17013
Phone (717) 241-5070

1211 Forge Rd
Ste 300
Carlisle, PA 17013
Phone (717) 218-3920

20 Capital Dr
Ste 100
Harrisburg, PA 17110
Phone (717) 724-6397

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

Interoperability endpoints

  • Direct secure messaging: awali122107@direct.geisinger.edu

Organizations & group practices 3

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 11

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1649273764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "717-724-6450",
            "fax_number": "717-724-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 POPLAR CHURCH RD",
            "address_2": "SUITE 400",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112203",
            "telephone_number": "717-724-6450",
            "fax_number": "717-724-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALI",
        "first_name": "ANDREAS",
        "middle_name": "UJDUD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD068378L",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "MD068378L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017687160001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060054509",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awali122107@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "875 Poplar Church Rd",
            "address_2": "Suite 400",
            "city": "Camp Hill",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170112203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

Verify at the official NPI Registry.