Individual provider Active NPI

Elaine H Zackai, M.D.

  • Clinical Genetics (M.D.) Physician
  • Philadelphia, PA
National Provider Identifier
1811904881
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
MD014103E Issued in PA
Practice address
3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Genetics
Philadelphia, PA 19104-4319
Phone
(215) 590-2920
Fax
(215) 590-3298
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cytogenetics Physician 207SC0300X MD014103E PA
Clinical Genetics (M.D.) Physician 207SG0201X MD014103E PA Primary
Pediatrics Physician 208000000X MD014103E PA
Pediatrics Physician 208000000X 25MA07256800 NJ
Clinical Cytogenetics Physician 207SC0300X 25MA07256800 NJ
Clinical Genetics (M.D.) Physician 207SG0201X 25MA07256800 NJ

Addresses

Primary practice location

3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Genetics
Philadelphia, PA 19104-4319

Mailing address

100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9258

Other identifiers 2

IdentifierTypeStateIssuer
0328600MedicaidNJ
000665287MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100519000121 PA Practitioner - Pediatric Medicine 2567591217 Reassigns benefits to 1 organization
I20100527000707 NJ Practitioner - Pediatric Medicine 2567591217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
New York University School of Medicine, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Health Care Associates IncGroup PAC ID 1355253527, 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

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates of New Jersey PC Pediatrics Current Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Mar 8, 2010 Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc Pediatrics CurrentSince Mar 8, 2010 Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Mar 8, 2010 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

1012 Laurel Oak Rd
Voorhees, NJ 08043
Phone (856) 435-0086

3401 Civic Center Blvd
#6
Philadelphia, PA 19104
Phone (215) 590-1190

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

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

3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169

Organizations & group practices 6

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1811904881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9258",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA - GENETICS",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-2920",
            "fax_number": "215-590-3298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACKAI",
        "first_name": "ELAINE",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SC0300X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Cytogenetics",
            "state": "PA",
            "license": "MD014103E",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "PA",
            "license": "MD014103E",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD014103E",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07256800",
            "primary": false
        },
        {
            "code": "207SC0300X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Cytogenetics",
            "state": "NJ",
            "license": "25MA07256800",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "NJ",
            "license": "25MA07256800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0328600",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000665287",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.