NPIMap

Individual provider Active NPI

Ricca Aimee Ando, DO

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1871721456
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS015497 Issued in PA
Practice address
4623 Spruce Street
Philadelphia, PA 19139-4542
Phone
(215) 474-6100
NPI assigned
Jun 23, 2009
Last updated
Jun 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT012823 PA
Family Medicine Physician 207Q00000X OS015497 PA Primary

Addresses

Primary practice location

4623 Spruce Street
Philadelphia, PA 19139-4542

Mailing address

4623 Spruce Street
Philadelphia, PA 19139-4542
Phone (215) 474-6100

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
I20120615000388 PA Practitioner - Family Practice 2264696582 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4536 Spruce St
Philadelphia, PA 19139-4525
Phone (215) 474-6100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT012823PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Current Accepting new patients
University of Penn - Medical Group CurrentSince Mar 1, 2020 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 2, 2012 Accepting new patients
University of Penn-Medical Group CurrentSince Mar 1, 2020 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Jul 2, 2012 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Family Medicine Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Past Accepting new patients

Locations

1800 Lombard St
Ste 206
Philadelphia, PA 19146
Phone (215) 615-2222

4623 Spruce St
Philadelphia, PA 19139
Phone (215) 474-6100

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 7

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 4

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": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338768000000",
    "number": "1871721456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4623 SPRUCE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191394542",
            "telephone_number": "215-474-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4623 SPRUCE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191394542",
            "telephone_number": "215-474-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDO",
        "first_name": "RICCA",
        "middle_name": "AIMEE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2012-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT012823",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS015497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.