Individual provider Active NPI

Radu Alexandru Nedelcoviciu, MD

  • Surgery Physician
  • Dover, DE
National Provider Identifier
1700034766
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD444229 Issued in PA
Practice address
724 S New St
Dover, DE 19904-3540
Phone
(302) 674-4070
Fax
(302) 672-2315
NPI assigned
Sep 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT 189899 PA
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X MD444229 PA Primary
Surgery Physician 208600000X C1-0011143 DE

Addresses

Primary practice location

724 S New St
Dover, DE 19904-3540

Mailing address

1100 Walnut St
FL 5
Philadelphia, PA 19107-4944
Phone (302) 674-3970

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200825002950 PA Practitioner - General Surgery 8325350010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (610) 642-1908

1100 Walnut St
Mob 5TH Floor
Philadelphia, PA 19107-5563
Phone (215) 955-6750

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD444229PAMDSurgery Physician
MT 189899PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Single Specialty CurrentSince Jul 1, 2023 Accepting new patients
Jefferson University Physicians Single Specialty CurrentSince Sep 1, 2020 Accepting new patients
Main Line Hospitals, Inc. Past Accepting new patients
Jefferson University Physicians Single Specialty Past Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients

Locations

640 S State St
#742
Dover, DE 19901

640 S State St
Bldg 742
Dover, DE 19901

640 S State St
Dover, DE 19901
Phone (302) 744-4700

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

255 W Lancaster Ave
Ste 331
Paoli, PA 19301
Phone (484) 527-2232

1101 Chestnut St
#8
Philadelphia, PA 19107
Phone (215) 955-5869

1100 Walnut St
Fl 5
Philadelphia, PA 19107
Phone (215) 955-6750

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

100 E Lancaster Ave
#275
Wynnewood, PA 19096
Phone (215) 622-3743

Organizations & group practices 5

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 5

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1700034766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WALNUT ST",
            "address_2": "FL 5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074944",
            "telephone_number": "302-674-3970",
            "fax_number": "302-672-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 S NEW ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199043540",
            "telephone_number": "302-674-4070",
            "fax_number": "302-672-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEDELCOVICIU",
        "first_name": "RADU",
        "middle_name": "ALEXANDRU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT 189899",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD444229",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DE",
            "license": "C1-0011143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.