NPIMap

Individual provider Active NPI

Theodore Burden, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1811980030
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD020774E Issued in PA
Practice address
2100 W Girard Ave
Philadelphia, PA 19130-1400
Phone
(215) 685-0800
Fax
(215) 685-0846
NPI assigned
Aug 23, 2005
Last updated
Jul 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD020774E PA Primary

Addresses

Primary practice location

2100 W Girard Ave
Philadelphia, PA 19130-1400

Mailing address

PO Box 820933
Philadelphia, PA 19182-0933
Phone (215) 926-9022

Other identifiers 7

IdentifierTypeStateIssuer
128306OtherPAHIGHMARK BLUE SHIELD
000804021MedicaidPA
0054331000OtherPAINDEPENDENCE BLUE CROSS
597586OtherPAMEDICARE GROUP
1019558OtherPAKEYSTONE MERCY HEALTH
CD4829OtherPARAILROAD MEDICARE TPI GROUP
P00037862OtherPARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071030000403 PA Practitioner - Internal Medicine 0143317792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Hahnemann University College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Medical CenterGroup PAC ID 7315132537, 20 clinicians

Practice addresses (Care Compare)

521 W Girard Ave
Philadelphia, PA 19123-1428
Phone (215) 440-9547

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.2 of 100Reported as group
Quality
70
Promoting interoperability
93
Improvement activities
20
Cost
88.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Medical Center Internal Medicine CurrentSince Jan 23, 2018 Accepting new patients
Bala Nursing & Ret CNTR LTD Ptrshp Ford Rd Corp Past Accepting new patients
Temple Physicians Inc Past Accepting new patients
CP Operating LLC Past Accepting new patients
Yeadon SNF Operations LLC Past Accepting new patients
Care Pavilion Operating, LLC Past Accepting new patients
Temple Physicians Inc Internal Medicine Past Accepting new patients
Temple Physicians Inc Past Accepting new patients
Centennial Healthcare, LLC Past Accepting new patients
Temple Physicians Inc Past Accepting new patients

Locations

208 W Chelten Ave
Philadelphia, PA 19144
Phone (215) 849-3104

521 W Girard Ave
Philadelphia, PA 19123
Phone (215) 440-9547

6212 Walnut St
Philadelphia, PA 19139
Phone (215) 476-6264

6445 Germantown Ave
Philadelphia, PA 19119
Phone (215) 438-5268

7515 Stenton Ave
Philadelphia, PA 19150
Phone (215) 842-5246

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25233/brand/1/csg/1/fhir/r4
  • Direct secure messaging: theodore.burden.1@25233.direct.athenahealth.com

Organizations & group practices 10

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 8

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1811980030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820933",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191820933",
            "telephone_number": "215-926-9022",
            "fax_number": "215-226-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W GIRARD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191301400",
            "telephone_number": "215-685-0800",
            "fax_number": "215-685-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDEN",
        "first_name": "THEODORE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD020774E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "128306",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000804021",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0054331000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "597586",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY HEALTH",
            "identifier": "1019558",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE TPI GROUP",
            "identifier": "CD4829",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00037862",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.