Individual provider Active NPI

Alejandra Wortman, M.D.

  • Child & Adolescent Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1861546251
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
478063 Issued in PA
Practice address
255 S 17TH St Ste 2900
Philadelphia, PA 19103-6201
Phone
(203) 869-5505
Fax
(038) 695-5042
NPI assigned
Jan 22, 2007
Last updated
Jan 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 216123 NY
Child & Adolescent Psychiatry Physician 2084P0804X 039844 CT
Child & Adolescent Psychiatry Physician 2084P0804X 478063 PA Primary

Addresses

Primary practice location

255 S 17TH St Ste 2900
Philadelphia, PA 19103-6201

Mailing address

50 S 16TH St Unit 4310
Philadelphia, PA 19102-2533
Phone (203) 869-5505

Other practice location 1

500 W Putnam Ave Ste 400
Greenwich, CT 06830-6096
Phone (203) 869-5505

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
039844CTMDChild & Adolescent Psychiatry Physician
216123NYMDChild & Adolescent Psychiatry Physician
478063PAMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1861546251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S 16TH ST UNIT 4310",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022533",
            "telephone_number": "203-869-5505",
            "fax_number": "203-869-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST STE 2900",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036201",
            "telephone_number": "203-869-5505",
            "fax_number": "038-695-5042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Putnam Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Greenwich",
            "state": "CT",
            "postal_code": "068306096",
            "country_code": "US",
            "telephone_number": "203-869-5505",
            "fax_number": "203-869-5504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WORTMAN",
        "first_name": "ALEJANDRA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "216123",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "039844",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "478063",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 22, 2024; 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.