Individual provider Active NPI

Bhradeev Sivasambu, MD

  • Cardiovascular Disease Physician
  • Philadelphia, PA
National Provider Identifier
1720355365
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD476591 Issued in PA
Practice address
10800 Knights Rd
Philadelphia, PA 19114-4200
Phone
(215) 612-4000
NPI assigned
Nov 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD476591 PA Primary
Internal Medicine Physician 207R00000X 2014-01484 NC

Addresses

Primary practice location

10800 Knights Rd
Philadelphia, PA 19114-4200

Mailing address

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-5473

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
I20220520001814 PA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 5092933507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

261 Old York Rd
Suite 214
Jenkintown, PA 19046-3724
Phone (215) 885-4700

Hospital & facility affiliations

  • Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115
  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
  • Nazareth Hospital Hospital, Philadelphia, PA, CCN 390204

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014-01484NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physician Services Current Accepting new patients
Aria Health Physician Services Cardiovascular Disease CurrentSince Jul 1, 2022 Accepting new patients
Aria Health Physician Services CurrentSince Jul 1, 2022 Accepting new patients
Aria Health Physician Services Past Accepting new patients

Locations

2685 Knights Rd
Bensalem, PA 19020
Phone (215) 245-5775

261 Old York Rd
Ste 214
Jenkintown, PA 19046
Phone (215) 885-4700

240 Middletown Blvd
Ste 101C
Langhorne, PA 19047
Phone (215) 550-9999

5000 Frankford Ave
Ste 1B
Philadelphia, PA 19124
Phone (215) 583-2355

9501 Roosevelt Blvd
Ste 501
Philadelphia, PA 19114
Phone (215) 670-5000

4900 Frankford Ave
Philadelphia, PA 19124
Phone (215) 612-2610

10800 Knights Rd
Philadelphia, PA 19114
Phone (215) 612-2610

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 2

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": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1720355365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818",
            "telephone_number": "252-847-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVASAMBU",
        "first_name": "BHRADEEV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-28",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD476591",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2014-01484",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.