Active NPI
Katherine Deoreo Lackritz, MD
- Obstetrics & Gynecology Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD443245
- Practice address
- 834 Chestnut Street
Suite 300
Philadelphia, PA 19107-5127 - Phone
- (215) 955-5000
- Fax
- (215) 923-1089
- NPI assigned
- Apr 20, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 255785 | NY | |
| Obstetrics & Gynecology Physician | 207V00000X | MD443245 | PA | Primary |
Addresses
Primary practice location
834 Chestnut Street
Suite 300
Philadelphia, PA 19107-5127
Mailing address
834 Chestnut Street
Suite 300
Philadelphia, PA 19107-5127
Phone (215) 955-5000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- University of Vermont College of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
833 Chestnut St
Suite 1
Philadelphia, PA 19107-4420
Phone (215) 955-5000
Hospital & facility affiliations
- Thomas Jefferson University Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 255785 | NY | MD | Obstetrics & Gynecology Physician |
| MD443245 | PA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson University Physicians | Obstetrics & Gynecology | Current | Accepting new patients |
| Jefferson University Physicians | Past | Accepting new patients | |
| Thomas Jefferson University Hospitals Inc | Past | Accepting new patients |
Locations
2130 Spring Garden St
Fl 1
Philadelphia, PA 19130
Phone (215) 955-9555
834 Chestnut St
Ste 300
Philadelphia, PA 19107
Phone (215) 955-2117
925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760
833 Chestnut St
Fl 1
Philadelphia, PA 19107
Phone (215) 955-1085
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.
-
- General Practice Physician
- Philadelphia, PA
- NPI 1326093675
Obstetrics & Gynecology
-
- Gastroenterology Physician
- Phila, PA
- NPI 1205898723
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1215916002
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1215916002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313020800000",
"number": "1790001485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "834 CHESTNUT STREET",
"address_2": "SUITE 300",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075127",
"telephone_number": "215-955-5000",
"fax_number": "215-923-1089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "834 CHESTNUT STREET",
"address_2": "SUITE 300",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075127",
"telephone_number": "215-955-5000",
"fax_number": "215-923-1089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACKRITZ",
"first_name": "KATHERINE",
"middle_name": "DEOREO",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-20",
"last_updated": "2011-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NY",
"license": "255785",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "PA",
"license": "MD443245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.