NPIMap

Individual provider Active NPI

Michael A. Venditto, DO

  • Pulmonary Disease Physician
  • Philadelphia, PA
National Provider Identifier
1891797759
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
OS003980L Issued in PA
Practice address
4190 City Ave
Suite 315
Philadelphia, PA 19131-1626
Phone
(215) 871-6337
Fax
(215) 871-6347
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS003980L PA
Internal Medicine Physician 207R00000X 25MB06362800 NJ
Critical Care Medicine (Internal Medicine) Physician 207RC0200X OS003980L PA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25MB06362800 NJ
Pulmonary Disease Physician 207RP1001X OS003980L PA Primary
Pulmonary Disease Physician 207RP1001X 25MB06362800 NJ

Addresses

Primary practice location

4190 City Ave
Suite 315
Philadelphia, PA 19131-1626

Mailing address

4190 City Ave
Suite 315
Philadelphia, PA 19131-1626
Phone (215) 871-6337

Other identifiers 1

IdentifierTypeStateIssuer
000860728MedicaidPA

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS003980LPAMDInternal Medicine Physician
25MB06362800NJMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Management of Southeastern Pennsylvania Past Accepting new patients
Methodist Associates in Healthcare, Inc Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michael.venditto@direct.pcom.nextgenshare.com

Organizations & group practices 2

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1891797759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "address_2": "SUITE 315",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-871-6337",
            "fax_number": "215-871-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "address_2": "SUITE 315",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-871-6337",
            "fax_number": "215-871-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENDITTO",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS003980L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB06362800",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PA",
            "license": "OS003980L",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MB06362800",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "OS003980L",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MB06362800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000860728",
            "state": "PA"
        }
    ],
    "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 Mar 3, 2016; 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.