Active NPI
Michael L Podolsky, MD
- Obstetrics & Gynecology Physician
- Philadelphia, PA
National Provider Identifier
1689631525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD017288E
- Practice address
- 216 N Broad St
4TH Floor Feinstein
Philadelphia, PA 19102-1121 - Phone
- (215) 762-3600
- Fax
- (215) 762-4323
- NPI assigned
- Apr 26, 2006
- Last updated
- Aug 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD017288E | PA | Primary |
Addresses
Primary practice location
216 N Broad St
4TH Floor Feinstein
Philadelphia, PA 19102-1121
Mailing address
1601 Cherry St
Suite 11511
Philadelphia, PA 19102-1321
Phone (215) 255-7822
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000621934 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD017288E | PA | MD | Geriatric Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regional Womens Health Group LLC | Obstetrics & Gynecology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Axia Women's Health
- Obstetrics & Gynecology Physician
- Phoenixville, PA
- NPI 1750880118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187568000000",
"number": "1689631525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 CHERRY ST",
"address_2": "SUITE 11511",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191021321",
"telephone_number": "215-255-7822",
"fax_number": "215-255-7825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 N BROAD ST",
"address_2": "4TH FLOOR FEINSTEIN",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191021121",
"telephone_number": "215-762-3600",
"fax_number": "215-762-4323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PODOLSKY",
"first_name": "MICHAEL",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2007-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "PA",
"license": "MD017288E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000621934",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.