Individual provider Active NPI

Tamar J Preminger, MD

  • Adult Congenital Heart Disease Physician
  • Philadelphia, PA
National Provider Identifier
1649363938
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Congenital Heart Disease PhysicianTaxonomy code 207RA0002X
License
MD465445 Issued in PA
Practice address
3400 Civic Center Blvd
2 East
Philadelphia, PA 19104-5127
Phone
(215) 615-4949
NPI assigned
Oct 2, 2006
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X MD465445 PA
Adult Congenital Heart Disease Physician 207RA0002X MD465445 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd
2 East
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
2 East
Philadelphia, PA 19104-5127
Phone (215) 615-4949

Other identifiers 1

IdentifierTypeStateIssuer
0124903MedicaidOH

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
I20181025000123 PA Practitioner - Adult Congenital Heart Disease (Achd)Practitioner - Cardiovascular Disease (Cardiology) 2264438456 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD465445PAMDAdult Congenital Heart Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince Jan 25, 2021 Accepting new patients
Childrens Health Care Associates, Inc Current Accepting new patients
Childrens Health Care Associates, Inc Pediatric Cardiology CurrentSince Oct 1, 2018 Accepting new patients
Childen's Health Care Associates Inc. CurrentSince Oct 1, 2018 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 25, 2021 Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients
Childrens Health Care Associates of New Jersey PC Past Accepting new patients

Locations

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3400 Civic Center Blvd
Ste 2E
Philadelphia, PA 19104
Phone (215) 615-0820

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

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

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1649363938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "2 EAST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-615-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "2 EAST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-615-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREMINGER",
        "first_name": "TAMAR",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "PA",
            "license": "MD465445",
            "primary": false
        },
        {
            "code": "207RA0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adult Congenital Heart Disease",
            "state": "PA",
            "license": "MD465445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0124903",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.