Individual provider Active NPI

Elana McDonald, M.D.

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1902893787
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD421148 Issued in PA
Practice address
3380 Memphis St
Philadelphia, PA 19134-4510
Phone
(215) 426-5566
Fax
(215) 739-7304
NPI assigned
Oct 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD421148 PA Primary

Addresses

Primary practice location

3380 Memphis St
Philadelphia, PA 19134-4510

Mailing address

3380 Memphis St
Philadelphia, PA 19134-4510
Phone (215) 426-5566

Other names 1

  • Elana O Miles-McDonald Former name

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
MD421148PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Sister Docs Current Accepting new patients
Castor Pediatrics PC Pediatrics Past Accepting new patients
E&M Healthcare Pediatrics PastSince Feb 9, 2020 Accepting new patients
Memphis Street Pediatrics LLC Pediatrics Past Accepting new patients

Organizations & group practices 4

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1902893787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 MEMPHIS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344510",
            "telephone_number": "215-426-5566",
            "fax_number": "215-739-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 MEMPHIS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344510",
            "telephone_number": "215-426-5566",
            "fax_number": "215-739-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "ELANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD421148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELANA",
            "last_name": "MILES-MCDONALD",
            "middle_name": "O",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Apr 7, 2011; 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.