Charles M. Intenzo, M.D.

Primary specialty

Nuclear Radiology PhysicianTaxonomy code 2085N0904X

License

MD025932E Issued in PA

Practice address

111 S. 11TH Street
Suite 3390
Philadelphia, PA 19107-4824

Phone

(215) 955-2900

Fax

(215) 923-1562

NPI assigned

Jul 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 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

Specialty

Nuclear Medicine

Education

Hahnemann University College of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson University Radiology Associates LLCGroup PAC ID 7315845708, shared by 3 NPIs, 110 clinicians

Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Jeanes Radiology Associates LLC

  • Diagnostic Radiology Physician
  • Philadelphia, PA
  • NPI 1639110240
  Medicare reassignment NPD
• Jefferson University Radiology Associates LLC

  • Radiology Clinic/Center
  • Philadelphia, PA
  • NPI 1578512224

  Diagnostic Radiology

  Medicare reassignment NPD
• Jefferson University Physicians of New Jersey, P.C.

  • Internal Medicine Physician
  • Voorhees, NJ
  • NPI 1083039200
  Medicare reassignment NPD
• Jefferson University Radiology Associates, LLC

  • Radiology Clinic/Center
  • Marlton, NJ
  • NPI 1972169902

  Diagnostic Radiology

  Medicare reassignment NPD
• Jefferson University Radiology Associates, LLC

  • Radiology Clinic/Center
  • Philadelphia, PA
  • NPI 1063067635

  Diagnostic Radiology

  NPD
• Jefferson University Radiology Associates, LLC

  • Radiology Clinic/Center
  • Malvern, PA
  • NPI 1710492764

  Diagnostic Radiology

  NPD
• Imaging Professionals of Pennsylvania PC

  • Diagnostic Radiology Physician
  • Philadelphia, PA
  • NPI 1952394363
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1669405346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S. 11TH STREET",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-2900",
            "fax_number": "215-923-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S. 11TH STREET",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-2900",
            "fax_number": "215-923-1562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 N Oxford Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Langhorne",
            "state": "PA",
            "postal_code": "190478304",
            "country_code": "US",
            "telephone_number": "215-949-5111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10800 Knights Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191144200",
            "country_code": "US",
            "telephone_number": "215-612-4811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4900 Frankford Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191242618",
            "country_code": "US",
            "telephone_number": "215-831-2063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INTENZO",
        "first_name": "CHARLES",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD025932E",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "PA",
            "license": "MD025932E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001073932",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6377505",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010739320009",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Integrity Wound Physicians Inc
• Intense Care Medical Transport Inc
• Intensivist Group of Pennsylvania, PC
• Intentional Care Homecare LLC
• Intentional Healing Therapeutic Services LLC
• Interactive Communication LLC
• Interactive Physical Therapy
• Interamerican Behavioral Health Services, Inc.
• Intercommunity Action, Inc
• Intercommunity Action, Inc

• Nuclear Radiology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nuclear Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.