Active NPI
Wakengo Mahaniah, M.D.
- Family Medicine Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD435219
- Practice address
- 5000 Woodland Ave
Philadelphia, PA 19143-5137 - Phone
- (215) 726-9807
- Fax
- (215) 726-6424
- NPI assigned
- Feb 28, 2008
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD435219 | PA | Primary |
Addresses
Primary practice location
5000 Woodland Ave
Philadelphia, PA 19143-5137
Mailing address
1401 S 31St St
2ND Floor
Philadelphia, PA 19146-3506
Phone (215) 925-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102216961 | Medicaid | PA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Temple University School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1316 W Ontario St
Philadelphia, PA 19140-5220
Phone (215) 707-2400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD435219 | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Temple Faculty Practice Plan Inc | Current | Accepting new patients | |
| Greater Philadelphia Health Action, Inc. | Current | Accepting new patients | |
| Temple Faculty Practice Plan Inc | Current | Accepting new patients | |
| Greater Philadelphia Health Action Inc. | Current | Accepting new patients | |
| Temple Faculty Practice Plan, Inc | Current | Accepting new patients | |
| Greater Philadelphia Health Action Inc. | Current | Accepting new patients | |
| Temple Faculty Practice Plan Inc | Past | Accepting new patients |
Locations
8815 Germantown Ave
Fl 5
Philadelphia, PA 19118
Phone (215) 248-8145
100 E Lehigh Ave
Philadelphia, PA 19125
Phone (215) 707-1200
432 N 6th St
Philadelphia, PA 19123
Phone (215) 627-8000
5000 Woodland Ave
Philadelphia, PA 19143
Phone (215) 726-9807
8815 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8145
1999 W Hunting Park Ave
Philadelphia, PA 19140
Phone (215) 228-9300
3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807
1316 W Ontario St
Philadelphia, PA 19140
Phone (215) 707-2400
5501 Woodland Ave
Philadelphia, PA 19143
Phone (215) 724-4700
1401 S 31st St
#2
Philadelphia, PA 19146
Interoperability endpoints
- wakengo.mahaniah@49428401684484.direct.elationemr.com
Organizations & group practices 8
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.
-
- Anesthesiology Physician
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- NPI 1881176949
-
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1205140902
-
- Internal Medicine Physician
- Philadelphia, PA
- NPI 1508936071
-
- Dental Clinic/Center
- Philadelphia, PA
- NPI 1710040878
-
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1275151607
-
- Radiation Oncology Physician
- Philadelphia, PA
- NPI 1295218972
-
- Urology Physician
- Voorhees, NJ
- NPI 1407638794
-
- Dermatology Physician
- Philadelphia, PA
- NPI 1285116228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510617600000",
"number": "1710156294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 S 31ST ST",
"address_2": "2ND FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191463506",
"telephone_number": "215-925-2400",
"fax_number": "215-925-9162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 WOODLAND AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191435137",
"telephone_number": "215-726-9807",
"fax_number": "215-726-6424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHANIAH",
"first_name": "WAKENGO",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-28",
"last_updated": "2017-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD435219",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102216961",
"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 Nov 14, 2017; 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.