Individual provider Active NPI

Rebecca Ahrens-Nicklas, MD, PHD

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1770877904
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MT200141 Issued in PA
Practice address
34TH & Civic Center Boulevard, 9NW55
Chop-Pediatrics/Medical Genetics Residency Program
Philadelphia, PA 19104-4399
Phone
(215) 590-1220
Fax
(215) 590-2768
NPI assigned
Jun 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X MT200141 PA
Pediatrics Physician 208000000X MT200141 PA Primary

Addresses

Primary practice location

34TH & Civic Center Boulevard, 9NW55
Chop-Pediatrics/Medical Genetics Residency Program
Philadelphia, PA 19104-4399

Mailing address

34TH & Civic Center Boulevard, 9NW55
Chop-Pediatrics/Medical Genetics Residency Program
Philadelphia, PA 19104-4399
Phone (215) 590-1220

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
I20170801000540 PA Practitioner - Pediatric Medicine 4284905811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
JS Weill Medical College, Cornell University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Health Care Associates Inc 211 clinicians

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT200141PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Jun 7, 2017 Accepting new patients
Childrens Health Care Associates, Inc CurrentSince Jun 7, 2017 Accepting new patients

Locations

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

Organizations & group practices 3

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": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1770877904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34TH & CIVIC CENTER BOULEVARD, 9NW55",
            "address_2": "CHOP-PEDIATRICS/MEDICAL GENETICS RESIDENCY PROGRAM",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044399",
            "telephone_number": "215-590-1220",
            "fax_number": "215-590-2768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34TH & CIVIC CENTER BOULEVARD, 9NW55",
            "address_2": "CHOP-PEDIATRICS/MEDICAL GENETICS RESIDENCY PROGRAM",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044399",
            "telephone_number": "215-590-1220",
            "fax_number": "215-590-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHRENS-NICKLAS",
        "first_name": "REBECCA",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "PA",
            "license": "MT200141",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT200141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.