Northeast Primary Care, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD027187-E Issued in PA

Legal business name

NORTHEAST PRIMARY CARE, PC

Practice address

8151 Revere St
1St Floor
Philadelphia, PA 19152-3002

Phone

(215) 624-3000

Fax

(215) 624-6855

NPI assigned

Feb 9, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Daria L. Dykyj

Title

Office Manager

Phone

(215) 624-3000

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roman Dykyj Jr., M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1891882973
  Medicare reassignment

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265673600000",
    "number": "1760714208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8151 REVERE STREET",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523002",
            "telephone_number": "215-624-3000",
            "fax_number": "215-624-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8151 REVERE ST",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523002",
            "telephone_number": "215-624-3000",
            "fax_number": "215-624-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PRIMARY CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-09",
        "last_updated": "2010-02-09",
        "status": "A",
        "authorized_official_last_name": "DYKYJ",
        "authorized_official_first_name": "DARIA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "215-624-3000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD027187-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1891882973",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northeast P.E.T Imaging, L.L.C (Northeast P.E.T Imaging)
• Northeast Pain Management Center P C
• Northeast Pediatric Dental LLC (Dentistry for Children)
• Northeast Philadelphia Dialysis Center LLC
• Northeast Philadelphia Vascular Surgeons PC
• Northeast Spine and Rehabilitaion Center LLC
• Northeast Treatment Center, Inc
• Northeast Treatment Center, Inc
• Northeast Treatment Center, Inc.
• Northeast Treatment Centers

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.