Individual provider Active NPI

Misha Dewan, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Philadelphia, PA
National Provider Identifier
1649407578
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
MD448671 Issued in PA
Practice address
1200 W Tabor Road
4TH Floor-Moss Building
Philadelphia, PA 19141-3019
Phone
(215) 456-6815
Fax
(215) 456-6803
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 53310 MN
Anesthesiology Physician 207L00000X MD448671 PA
Internal Medicine Physician 207R00000X MT194659 PA
Pain Medicine (Anesthesiology) Physician 207LP2900X MD448671 PA Primary

Addresses

Primary practice location

1200 W Tabor Road
4TH Floor-Moss Building
Philadelphia, PA 19141-3019

Mailing address

5501 Old York Road
Korman-Suite 202
Philadelphia, PA 19141-3018
Phone (215) 254-2612

Other practice location 1

721 Dresher Rd
Horsham, PA 19044-2220
Phone (215) 277-5888

Other practice location 2

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-1858

Other identifiers 1

IdentifierTypeStateIssuer
ENROLLEDMedicaidMN

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
I20141124000370 PA Practitioner - AnesthesiologyPractitioner - Pain Management 8820112972 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Anesthesia Services PCGroup PAC ID 3173437613, 437 clinicians

Practice addresses (Care Compare)

1200 Old York Rd
Abington, PA 19001-3720
Phone (215) 481-2000

744 W Lancaster Ave
Wayne, PA 19082-2523
Phone (610) 645-2000

Hospital & facility affiliations

  • Jefferson Abington Hospital Hospital, Abington, PA, CCN 390231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT194659PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Anesthesiology Associates, LTD Anesthesiology CurrentSince Mar 17, 2022 Accepting new patients
Children'S Anesthesiology Associates, LTD Anesthesiology CurrentSince Mar 17, 2022 Accepting new patients
Childrens Health Care Associates of New Jersey PC Past Accepting new patients
Children'S Surgical Associates LTD Past Accepting new patients

Locations

3401 Civic Center Blvd
Ste 9329
Philadelphia, PA 19104
Phone (267) 425-9300

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

Organizations & group practices 5

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 1

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": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1649407578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK ROAD",
            "address_2": "KORMAN-SUITE 202",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-254-2612",
            "fax_number": "215-456-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W TABOR ROAD",
            "address_2": "4TH FLOOR-MOSS BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413019",
            "telephone_number": "215-456-6815",
            "fax_number": "215-456-6803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 Dresher Rd",
            "address_purpose": "LOCATION",
            "city": "Horsham",
            "state": "PA",
            "postal_code": "190442220",
            "country_code": "US",
            "telephone_number": "215-277-5888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3401 Civic Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "215-590-1858",
            "fax_number": "215-590-1415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWAN",
        "first_name": "MISHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "53310",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD448671",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT194659",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "MD448671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.