NPIMap

Individual provider Active NPI

Bailey Victoria Tudor

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1679351217
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA064863 Issued in PA
Practice address
1440 Mount Vernon St Apt 507
Philadelphia, PA 19130-3475
Phone
(508) 631-1551
NPI assigned
Sep 15, 2023
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA064863 PA Primary

Addresses

Primary practice location

1440 Mount Vernon St Apt 507
Philadelphia, PA 19130-3475

Mailing address

4145 Pechin St
Philadelphia, PA 19128-3515
Phone (508) 631-1551

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
I20250311002933 PA Practitioner - Physician Assistant 1850812488 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Temple University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line Emergency Med Associates LLCGroup PAC ID 9234034729, 51 clinicians
On Demand Urgent Care Group PCGroup PAC ID 5991029712, 95 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (484) 337-3583

1217 S Broad St
Philadelphia, PA 19147-4401
Phone (215) 999-1217

3356 Aramingo Ave
Philadelphia, PA 19134-4506
Phone (215) 999-3356

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA064863PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Emergency Med Associates LLC CurrentSince Nov 1, 2025 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Dec 8, 2024 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Dec 8, 2024 Accepting new patients
On Demand Urgent Care Group PC Past Accepting new patients

Locations

56 W Main St
Ste 305
Christiana, DE 19702

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Interoperability endpoints

  • Direct secure messaging: bailey.tudor.1@14965.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1679351217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4145 PECHIN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283515",
            "telephone_number": "508-631-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 MOUNT VERNON ST APT 507",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303475",
            "telephone_number": "508-631-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUDOR",
        "first_name": "BAILEY",
        "middle_name": "VICTORIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA064863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.