Active NPI
Nanichi Alexandra Ramos Roldan
- Pediatric Rehabilitation Medicine Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Rehabilitation Medicine Physician
- License
- MD485459
- Practice address
- 3500 Civic Center Blvd
Philadelphia, PA 19104-4395 - Phone
- (215) 590-1000
- NPI assigned
- Apr 4, 2018
- Last updated
- Sep 25, 2024
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | TRN31182 | FL | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 14837 | PR | |
| Pediatric Rehabilitation Medicine Physician | 2081P0010X | MD485459 | PA | Primary |
Addresses
Primary practice location
3500 Civic Center Blvd
Philadelphia, PA 19104-4395
Mailing address
24C Calle Barranquitas
Caguas, PR 00727-4950
Other practice location 1
Area de Centro Medico
PM&R Department
San Juan, PR 00921
Phone (787) 751-9625
Other practice location 2
Area de Centro Medico
1156-1178 Cll 62 SE
San Juan, PR 00921
Phone (787) 751-9625
Other practice location 3
1611 NW 12th Ave
Miami, FL 33136-1005
Phone (305) 585-9600
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD485459 | PA | MD | Pediatric Rehabilitation Medicine Physician |
| TRN31182 | FL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Health Care Associates of New Jersey PC | 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 Chca NJ
- Pediatrics Physician
- Voorhees, NJ
- NPI 1427152917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1710483029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24C CALLE BARRANQUITAS",
"city": "CAGUAS",
"state": "PR",
"postal_code": "007274950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044395",
"telephone_number": "215-590-1000"
}
],
"practiceLocations": [
{
"address_1": "Area de Centro Medico",
"address_2": "PM&R Department",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "00921",
"country_code": "US",
"telephone_number": "787-751-9625",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "Area de Centro Medico",
"address_2": "1156-1178 Cll 62 SE",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "00921",
"country_code": "US",
"telephone_number": "787-751-9625",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1611 NW 12th Ave",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "331361005",
"country_code": "US",
"telephone_number": "305-585-9600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAMOS ROLDAN",
"first_name": "NANICHI",
"middle_name": "ALEXANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-04",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "TRN31182",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "PR",
"license": "14837",
"primary": false
},
{
"code": "2081P0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
"state": "PA",
"license": "MD485459",
"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 Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.