Nichelle Secorra Adegbite-Maraventano, M.D.
Individual provider Active NPI Pediatrics Physician · Philadelphia, PA
NPI 1891003208 · NPPES record last updated Feb 26, 2026
Key facts
- NPI
- 1891003208
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD437835 (PA)
- Practice address
- 3401 Civic Center Blvd
Children'S Hospital of Philadelphia
Philadelphia, PA 19104-4319 - Phone
- (215) 590-1000
- Fax
- (215) 590-2180
- NPI assigned
- Sep 20, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- George Washington University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- City of Philadelphia
Practice addresses (Care Compare)
2230 Cottman Ave
Philadelphia, PA 19149-1230
Phone (215) 685-0602
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130916000188 | PA | Practitioner - Pediatric Medicine |
8123262011 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Health Care Associates, Inc | Pediatrics | Current | Accepting new patients |
| City of Philadelphia | Current |
Accepting new patients | |
| Childen'S Health Care Associates Inc. | Current |
Accepting new patients | |
| Peds 360 Plus Corp | Pediatrics | Current |
Accepting new patients |
| City of Philadelphia | Current | Accepting new patients | |
| City of Philadelphia | Current |
Accepting new patients | |
| Childrens Health Care Associates, Inc | Pediatrics | Current |
Accepting new patients |
| City of Philadelphia | Past | Accepting new patients |
Locations
361 Highland Ave
Ste 206
Jenkintown, PA 19046
Phone (267) 594-8734
1101 Market St
Fl 10
Philadelphia, PA 19107
3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040
4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600
131 E Chelten Ave
Philadelphia, PA 19144
Phone (215) 685-2933
Interoperability endpoints
- nichelle.adegbitemaraventano@pdphahs.eclinicaldirectplus.com
- nichelle.adegbite-maraventano.1@28228.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD437835 | PA | Yes |
Addresses
Primary practice location
3401 Civic Center Blvd
Children'S Hospital of Philadelphia
Philadelphia, PA 19104-4319
Mailing address
100 Penn Square East - North Tower
Wanamaker BLDG - 9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9232
Other providers in Philadelphia, PA
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- Oluwakemi Adedokun
- Rasidat Adeduntan
- Abidemi Adetoyese Adegbola
- Ibijoke Helen Adegboyega
- Enitan Adegite
- Tatiana Adejare
- Olukemi A Adekanmbi
All providers in Philadelphia, PA · Pediatrics Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.