Individual provider Active NPI

Beverly G Coleman, MD

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1669400701
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD017175E Issued in PA
Practice address
3401 Civic Center Blvd
Radiology Associates of Children's Hospital
Philadelphia, PA 19104-4319
Phone
(215) 590-1000
Fax
(215) 590-9348
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD017175E PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Radiology Associates of Children's Hospital
Philadelphia, PA 19104-4319

Mailing address

100 Penn Square East, 9TH FL North Tower
Radiology Associates of Children's Hospital
Philadelphia, PA 19104-4319
Phone (267) 425-9232

Other identifiers 1

IdentifierTypeStateIssuer
0006954370001MedicaidPA

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
I20060112000685 PA Practitioner - Diagnostic Radiology 8123041407 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD017175EPAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Diagnostic Radiology CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

3400 Spruce St
#588
Philadelphia, PA 19104
Phone (800) 998-4505

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

250 King of Prussia Rd
Ste 3
Radnor, PA 19087
Phone (610) 902-1800

420 W Linfield Trappe Rd
Royersford, PA 19468
Phone (610) 279-8686

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

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, 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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1669400701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PENN SQUARE EAST, 9TH FL NORTH TOWER",
            "address_2": "RADIOLOGY ASSOCIATES OF CHILDREN'S HOSPITAL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "267-425-9232",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "RADIOLOGY ASSOCIATES OF CHILDREN'S HOSPITAL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1000",
            "fax_number": "215-590-9348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "BEVERLY",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD017175E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006954370001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.