Active NPI
Marsha Ayzen Elkhunovich, M.D.
- Pediatrics Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MT188294
- Practice address
- 34TH & Civic Center Blvd
Children's Hospital of Philadelphia
Philadelphia, PA 19104-4399 - Phone
- (215) 590-1000
- Fax
- (215) 590-2204
- NPI assigned
- Aug 5, 2007
- Last updated
- Jul 1, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MT188294 | PA | Primary |
Addresses
Primary practice location
34TH & Civic Center Blvd
Children's Hospital of Philadelphia
Philadelphia, PA 19104-4399
Mailing address
3535 Market St
12TH Floor, Suite 1220 - Chop Dept of Msa
Philadelphia, PA 19104-3309
Phone (215) 590-4670
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT188294 | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Hospital Los Angeles Medical Group, Inc. | Pediatrics | Current | Accepting new patients |
| Childrens Hospital of Los Angeles | Past | Accepting new patients | |
| Children's Hospital Los Angeles | Past | Accepting new patients |
Locations
3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550
4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Los Angeles, CA
- NPI 1265530653
Pediatrics
-
- Children's Chronic Disease Hospital
- Los Angeles, CA
- NPI 1366527954
-
- Children's Hospital
- Los Angeles, CA
- NPI 1124073366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467331200000",
"number": "1710178934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3535 MARKET ST",
"address_2": "12TH FLOOR, SUITE 1220 - CHOP DEPT OF MSA",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043309",
"telephone_number": "215-590-4670",
"fax_number": "215-590-2204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34TH & CIVIC CENTER BLVD",
"address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044399",
"telephone_number": "215-590-1000",
"fax_number": "215-590-2204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELKHUNOVICH",
"first_name": "MARSHA",
"middle_name": "AYZEN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-05",
"last_updated": "2016-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MT188294",
"primary": true
}
],
"identifiers": [],
"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 Jul 1, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.