Individual provider Active NPI

Alexandra I Karetas, MD

  • Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1821086067
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD 008095 E Issued in PA
Practice address
3401 N Broad St
3Rd FL Out Patient BLDG
Philadelphia, PA 19140-5103
Phone
(215) 707-3326
Fax
(215) 707-8028
NPI assigned
Oct 12, 2005
Last updated
Jan 21, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD 008095 E PA Primary

Addresses

Primary practice location

3401 N Broad St
3Rd FL Out Patient BLDG
Philadelphia, PA 19140-5103

Mailing address

P.O Box 8277783
Philadelphia, PA 19185-7783
Phone (215) 707-3326

Other identifiers 1

IdentifierTypeStateIssuer
0008648250006MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 008095 EPAMDAnesthesiology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264032000000",
    "number": "1821086067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX 8277783",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191857783",
            "telephone_number": "215-707-3326",
            "fax_number": "215-707-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "address_2": "3RD FL OUT PATIENT BLDG",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3326",
            "fax_number": "215-707-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARETAS",
        "first_name": "ALEXANDRA",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2010-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD 008095 E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008648250006",
            "state": "PA"
        }
    ],
    "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 Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.