Ali R Kadkhoda, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS015315 Issued in PA

Practice address

301 E City Ave
Suite 100
Bala Cynwyd, PA 19004-1708

Phone

(610) 617-1300

Fax

(610) 617-0199

NPI assigned

Jun 1, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Philadelphia College of Osteopathic Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Main Line Health Home Care & Hospice - Home Health Home health agency, Radnor, PA, CCN 397012
• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
• Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
• Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
• Paoli Hospital Hospital, Paoli, PA, CCN 390153

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kadkhodaa@clfm-pa.direct.office.nextgen.com

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD

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

• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation
• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation
• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Bryn Mawr, PA
  • NPI 1508971441
  Care Compare affiliation
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  Care Compare affiliation

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1699094607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E CITY AVE",
            "address_2": "SUITE 100",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041708",
            "telephone_number": "610-617-1300",
            "fax_number": "610-617-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E CITY AVE",
            "address_2": "SUITE 100",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041708",
            "telephone_number": "610-617-1300",
            "fax_number": "610-617-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADKHODA",
        "first_name": "ALI",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-01",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS015315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.