NPIMap

Individual provider Active NPI

Adam Justin Waxman, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1669766275
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD449902 Issued in PA
Practice address
3400 Civic Center Boulevard
Perelman Center for Advanced Medicine
Philadelphia, PA 19104
Phone
(215) 615-5858
NPI assigned
Jun 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MD449902 PA
Internal Medicine Physician 207R00000X MD449902 PA Primary

Addresses

Primary practice location

3400 Civic Center Boulevard
Perelman Center for Advanced Medicine
Philadelphia, PA 19104

Mailing address

3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Phone (215) 615-5858

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
I20140703001391 PA Practitioner - Hematology/Oncology 4688899792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Duke University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 615-5858

Hospital & facility affiliations

  • Penn Medicine Home Health Home health agency, Bala Cynwyd, PA, CCN 397125
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100
  • University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as individual
Quality
100
Improvement activities
0
Cost
88.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD449902PAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Past Accepting new patients

Organizations & group practices 2

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 9

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": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1669766275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-615-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BOULEVARD",
            "address_2": "PERELMAN CENTER FOR ADVANCED MEDICINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-615-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAXMAN",
        "first_name": "ADAM",
        "middle_name": "JUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PA",
            "license": "MD449902",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD449902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.