Individual provider Active NPI

Lucas Barreira Angelim, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1770195489
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT219872 Issued in PA
Practice address
5501 Old York Rd Ste 1
Philadelphia, PA 19141-3098
Phone
(215) 456-8520
NPI assigned
Aug 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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 MT219872 PA Primary

Addresses

Primary practice location

5501 Old York Rd Ste 1
Philadelphia, PA 19141-3098

Mailing address

5501 Old York Rd Ste 1
Philadelphia, PA 19141-3098
Phone (215) 456-8520

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
I20230811001147 PA Practitioner - Internal Medicine 1052773728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5501 Old York Rd Community Prac Ctr
Philadelphia, PA 19141-3092
Phone (215) 456-6500

Hospital & facility affiliations

  • Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT219872PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Jul 1, 2023 Accepting new patients
Einstein Practice Plan Inc Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Einstein Practice Plan Inc Internal Medicine Past Accepting new patients
Albert Einstein Medical Center Past Accepting new patients

Locations

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

5501 Old York Rd
#B
Philadelphia, PA 19141
Phone (215) 456-8220

5401 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-8220

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Ste 1
Philadelphia, PA 19141
Phone (215) 456-6500

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.

Hospital & facility affiliations 1

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": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1770195489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD STE 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413098",
            "telephone_number": "215-456-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD STE 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413098",
            "telephone_number": "215-456-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARREIRA ANGELIM",
        "first_name": "LUCAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT219872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.