NPIMap

Organization Active NPI

Drexel University

Doing business as Drexel Internal Medicine Primary Care

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1861725194
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DREXEL UNIVERSITY
Doing business as
Drexel Internal Medicine Primary Care
Practice address
205 N Broad St
Suite 100
Philadelphia, PA 19107-1554
Phone
(215) 587-8008
Fax
(215) 587-6248
NPI assigned
Sep 18, 2009
Last updated
Jan 25, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Authorized official

Name
David Janiec
Title
Director of Payer Contracting
Phone
(215) 255-7766

Specialties & licenses 1

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

Addresses

Primary practice location

205 N Broad St
Suite 100
Philadelphia, PA 19107-1554

Mailing address

1601 Cherry St
Suite 11511
Philadelphia, PA 19102-1321
Phone (215) 255-7822

Other names 1

  • Drexel Internal Medicine Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140729001682 PA Part B Supplier - Clinic/Group Practice 5496664740 Receives reassigned benefits from 340 practitioners
45 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA; Warminster, PA; Elkins Park, PA

Other NPIs on the same Medicare enrollment 45

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 45

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1861725194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021321",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST",
            "address_2": "SUITE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071554",
            "telephone_number": "215-587-8008",
            "fax_number": "215-587-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREXEL UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-18",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "JANIEC",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER CONTRACTING",
        "authorized_official_telephone_number": "215-255-7766"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drexel Internal Medicine Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.