Individual provider Active NPI

Christopher Formal, MD

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
National Provider Identifier
1801874656
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD024740E Issued in PA
Practice address
1513 Race St
Philadelphia, PA 19102-1125
Phone
(215) 587-3159
Fax
(215) 587-9405
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD024740E PA Primary

Addresses

Primary practice location

1513 Race St
Philadelphia, PA 19102-1125

Mailing address

1513 Race St
Philadelphia, PA 19102-1125
Phone (215) 587-3159

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
I20070129000479 PA Practitioner - Physical Medicine and Rehabilitation 0042211369 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD024740EPAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Sep 1, 2022 Accepting new patients
Methodist Associates in Healthcare, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Methodist Associates in Healthcare, Inc Current Accepting new patients
Franklintown Rehabilitation Associates, LLC Physical Medicine & Rehabilitation Past Accepting new patients

Locations

1513 Race St
Philadelphia, PA 19102
Phone (215) 587-3000

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

Organizations & group practices 4

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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1801874656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 RACE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021125",
            "telephone_number": "215-587-3159",
            "fax_number": "215-587-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 RACE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021125",
            "telephone_number": "215-587-3159",
            "fax_number": "215-587-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAL",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD024740E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.