NPIMap

Individual provider Active NPI

Michael Gavino Decapua, MD

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
National Provider Identifier
1710564984
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD488803 Issued in PA
Practice address
1800 Lombard Street
Ground Floor
Philadelphia, PA 19146-1498
Phone
(215) 893-2600
Fax
(215) 893-2610
NPI assigned
Mar 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD488803 PA Primary
Physical Medicine & Rehabilitation Physician 208100000X 25MA13015400 NJ

Addresses

Primary practice location

1800 Lombard Street
Ground Floor
Philadelphia, PA 19146-1498

Mailing address

1800 Lombard Street
Ground Floor
Philadelphia, PA 19146-1498
Phone (215) 893-2600

Other practice location 1

1865 Route 70 East
Ste 220
Cherry Hill, NJ 08003-2013
Phone (856) 433-2641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250616001954 PA Practitioner - Physical Medicine and Rehabilitation 5799296844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Rutgers New Jersey Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

1800 Lombard Street Ground Floor
Phys Med and Rehab Ritten
Philadelphia, PA 19146-1498
Phone (215) 893-2600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Jul 1, 2025 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2025 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

1800 Lombard St
Philadelphia, PA 19146
Phone (215) 545-4173

801 Spruce St
Fl 3
Philadelphia, PA 19107
Phone (215) 627-5272

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 4

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 6

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1710564984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 LOMBARD STREET",
            "address_2": "GROUND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461498",
            "telephone_number": "215-893-2600",
            "fax_number": "215-893-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 LOMBARD STREET",
            "address_2": "GROUND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461498",
            "telephone_number": "215-893-2600",
            "fax_number": "215-893-2610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1865 Route 70 East",
            "address_2": "STE 220",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080032013",
            "country_code": "US",
            "telephone_number": "856-433-2641",
            "fax_number": "856-427-9468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECAPUA",
        "first_name": "MICHAEL",
        "middle_name": "GAVINO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD488803",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MA13015400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.