Individual provider Active NPI

Dimitrios Papanagnou, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1730349176
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD450140 Issued in PA
Practice address
1020 Sansom St
Suite 239
Philadelphia, PA 19107-5002
Phone
(215) 955-6844
Fax
(215) 955-2526
NPI assigned
Jun 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 390200000S NY
Emergency Medicine Physician 207P00000X MD450140 PA Primary

Addresses

Primary practice location

1020 Sansom St
Suite 239
Philadelphia, PA 19107-5002

Mailing address

1020 Sansom St
Suite 239
Philadelphia, PA 19107-5002
Phone (215) 955-6844

Other identifiers 2

IdentifierTypeStateIssuer
0391832MedicaidNJ
102888810MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD450140PAMDEmergency Medicine Physician
390200000SNYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Acute Care Physicians, PC CurrentSince Jul 1, 2015 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Jul 1, 2015 Accepting new patients
Jefferson University Physicians Emergency Medicine CurrentSince Jan 1, 2014 Accepting new patients

Locations

700 Walnut St
Philadelphia, PA 19106
Phone (215) 503-7300

2301 S Broad St
Fl 1
Philadelphia, PA 19148
Phone (215) 952-9136

1020 Sansom St
#239
Philadelphia, PA 19107
Phone (215) 955-6844

1020 Sansom St
Ste 239
Philadelphia, PA 19107
Phone (215) 955-6844

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398297600000",
    "number": "1730349176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST",
            "address_2": "SUITE 239",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075002",
            "telephone_number": "215-955-6844",
            "fax_number": "215-955-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST",
            "address_2": "SUITE 239",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075002",
            "telephone_number": "215-955-6844",
            "fax_number": "215-955-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPANAGNOU",
        "first_name": "DIMITRIOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2014-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "390200000S",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD450140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0391832",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102888810",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.