Individual provider Active NPI

Rahul Yadav, M.B.B.S. M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1790030427
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD455176 Issued in PA
Practice address
2301 S Broad St
2ND Floor
Philadelphia, PA 19148-3542
Phone
(215) 955-9434
NPI assigned
Jul 18, 2012
Last updated
Oct 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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 NU
Internal Medicine Physician 207R00000X MD455176 PA Primary

Addresses

Primary practice location

2301 S Broad St
2ND Floor
Philadelphia, PA 19148-3542

Mailing address

2301 S Broad St
2ND Floor
Philadelphia, PA 19148-3542
Phone (215) 952-9434

Other identifiers 2

IdentifierTypeStateIssuer
103041458MedicaidPA
0473081MedicaidNJ

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
I20150807014639 PA Practitioner - Internal Medicine 8527372242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2301 S Broad St
Philadelphia, PA 19148-3542
Phone (215) 952-9323

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD455176PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Jul 1, 2015 Accepting new patients
Methodist Hospital Past Accepting new patients
Jefferson University Physicians Past Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients

Locations

111 S 11th St
Ste 8490
Philadelphia, PA 19107
Phone (215) 955-6161

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

2301 S Broad St
Fl 2
Philadelphia, PA 19148
Phone (215) 952-9148

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

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

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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1790030427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S BROAD ST",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191483542",
            "telephone_number": "215-952-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S BROAD ST",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191483542",
            "telephone_number": "215-955-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YADAV",
        "first_name": "RAHUL",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S. M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD455176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103041458",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0473081",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.