Individual provider Active NPI

Michael Nooromid, M.D.

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1760827497
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD472015 Issued in PA
Practice address
111 S 11TH St Ste 6270
Philadelphia, PA 19107-4824
Phone
(215) 955-4901
Fax
(215) 923-0835
NPI assigned
May 8, 2013
Last updated
Jun 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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
Surgery Physician 208600000X MD472015 PA Primary

Addresses

Primary practice location

111 S 11TH St Ste 6270
Philadelphia, PA 19107-4824

Mailing address

676 N. Saint Clair Street
Suite 650
Chicago, IL 60611

Other practice location 1

251 east Huron st
McGaw medical center
Chicago, IL 60611-2908
Phone (312) 503-7975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201209000160 PA Practitioner - Vascular Surgery 7517257835 Reassigns benefits to 2 organizations
I20251128000427 DE Practitioner - General Surgery 7517257835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
New York Medical College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

111 S 11TH St
Philadelphia, PA 19107-4824
Phone (215) 955-6540

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)11
Removal of tissue20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD472015PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Associates LLP CurrentSince Mar 1, 2025 Accepting new patients
Foot and Ankle Associates LLP CurrentSince Mar 1, 2025 Accepting new patients
Jefferson University Physicians Surgery CurrentSince Oct 1, 2020 Accepting new patients
The Nemours Foundation CurrentSince Oct 1, 2025 Accepting new patients
The Nemours Foundation CurrentSince Oct 1, 2025 Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients
Jefferson Radiation Oncology, LLC Past Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

1440 Conchester Hwy
Ste 10
Boothwyn, PA 19060
Phone (610) 459-3288

692 Unionville Rd
Kennett Square, PA 19348
Phone (610) 444-6520

1101 Chestnut St
Fl 9
Philadelphia, PA 19107
Phone (215) 503-1807

111 S 11th St
Ste 6270
Philadelphia, PA 19107
Phone (215) 955-6540

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

1 Commerce Blvd
Ste 102
West Grove, PA 19390
Phone (610) 345-0222

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1760827497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N. SAINT CLAIR STREET",
            "address_2": "SUITE 650",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST STE 6270",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-4901",
            "fax_number": "215-923-0835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 east Huron st",
            "address_2": "McGaw medical center",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112908",
            "country_code": "US",
            "telephone_number": "312-503-7975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOOROMID",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-08",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD472015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.