Individual provider Active NPI

Edinah Tendai Chikunguwo, DO

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1861056038
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OS023129 Issued in PA
Practice address
3535 Market St Ste 200
Philadelphia, PA 19104-3377
Phone
(215) 746-7248
Fax
(215) 746-7203
NPI assigned
Apr 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OS023129 PA Primary

Addresses

Primary practice location

3535 Market St Ste 200
Philadelphia, PA 19104-3377

Mailing address

3535 Market St Ste 200
Philadelphia, PA 19104-3377
Phone (215) 746-7248

Other practice location 1

501 S 54th St
Philadelphia, PA 19143-1900
Phone (215) 748-9000

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
I20231018000683 PA Practitioner - Psychiatry 7517292535 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS023129PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2024 Accepting new patients
Comhar Inc CurrentSince Aug 28, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2024 Accepting new patients
Comhar, Inc Psychiatry Current Accepting new patients

Locations

2055 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 427-5800

2600 N American St
Philadelphia, PA 19133
Phone (215) 426-1007

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

100 W Lehigh Ave
Philadelphia, PA 19133
Phone (215) 203-3000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1861056038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 MARKET ST STE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043377",
            "telephone_number": "215-746-7248",
            "fax_number": "215-746-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 MARKET ST STE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043377",
            "telephone_number": "215-746-7248",
            "fax_number": "215-746-7203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S 54th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191431900",
            "country_code": "US",
            "telephone_number": "215-748-9000",
            "fax_number": "215-746-6551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIKUNGUWO",
        "first_name": "EDINAH",
        "middle_name": "TENDAI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS023129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.