Individual provider Active NPI

John Cacciamani, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1740278654
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD066065L Issued in PA
Practice address
8815 Germantown Ave
5TH Floor
Philadelphia, PA 19118-2722
Phone
(215) 248-8145
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD066065L PA Primary

Addresses

Primary practice location

8815 Germantown Ave
5TH Floor
Philadelphia, PA 19118-2722

Mailing address

8815 Germantown Ave
Suite 40
Philadelphia, PA 19118-2722

Other identifiers 1

IdentifierTypeStateIssuer
1011780420001MedicaidPA

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
I20050307000369 PA Practitioner - Internal Medicine 3173577756 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan, Inc CurrentSince Oct 28, 2023 Accepting new patients
Chestnut Hill Clinic Company, LLC CurrentSince Jul 1, 2012 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Oct 28, 2023 Accepting new patients
Chestnut Hill Clinic Company, LLC Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients

Locations

1316 W Ontario St
Philadelphia, PA 19140
Phone (215) 707-2400

8815 Germantown Ave
Ste 40
Philadelphia, PA 19118
Phone (215) 242-4442

8815 Germantown Ave
Fl 5
Philadelphia, PA 19118
Phone (215) 248-8145

10 Shurs Ln
Philadelphia, PA 19127
Phone (215) 482-0899

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

8200 Flourtown Ave
Ste 2
Wyndmoor, PA 19038
Phone (215) 836-5100

Organizations & group practices 5

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1740278654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8815 GERMANTOWN AVE",
            "address_2": "SUITE 40",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191182722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8815 GERMANTOWN AVE",
            "address_2": "5TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191182722",
            "telephone_number": "215-248-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACCIAMANI",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD066065L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011780420001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.