NPIMap

Individual provider Active NPI

John Michael Ricely, DO

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1750919676
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OS024665 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5189
Phone
(215) 707-7237
Fax
(215) 707-9389
NPI assigned
Mar 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X OS024665 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5189

Mailing address

3401 N Broad St
Philadelphia, PA 19140-5189
Phone (215) 707-9211

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
I20250620001085 PA Practitioner - Diagnostic Radiology 0648601138 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Philadelphia College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of the Main Line P CGroup PAC ID 9931097193, 80 clinicians
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

2301 S Broad St
Philadelphia, PA 19148-3542
Phone (215) 952-9300

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (484) 565-1596

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3008

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Jul 1, 2025 Accepting new patients
Methodist Associates in Healthcare, Inc Diagnostic Radiology Current Accepting new patients
Methodist Associates in Healthcare, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 1, 2026 Accepting new patients
Radiology Associates of the Main Line P C Diagnostic Radiology CurrentSince Aug 1, 2025 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Mar 1, 2026 Accepting new patients

Locations

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

120 Valley Green Ln
Kng of Prussa, PA 19406
Phone (610) 526-3000

3855 West Chester Pike
Newtown Square, PA 19073
Phone (484) 337-6000

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

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

111 S 11th St
Ste G3390
Philadelphia, PA 19107
Phone (215) 955-2900

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 7

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 12

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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1750919676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405189",
            "telephone_number": "215-707-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405189",
            "telephone_number": "215-707-7237",
            "fax_number": "215-707-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICELY",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "OS024665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.