NPIMap

Organization Active NPI

Drexel University

Doing business as Drexel Vascular Surgery

  • Vascular Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1902900939
Registry record updated Jul 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
DREXEL UNIVERSITY
Doing business as
Drexel Vascular Surgery
Practice address
219 N Broad St
8TH Floor
Philadelphia, PA 19107-1519
Phone
(215) 762-4005
Fax
(215) 762-8572
NPI assigned
Sep 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2014

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
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X PA Primary

Addresses

Primary practice location

219 N Broad St
8TH Floor
Philadelphia, PA 19107-1519

Mailing address

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

Other names 1

  • Drexel Vascular Surgery 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 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404777600000",
    "number": "1902900939",
    "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": "219 N BROAD ST",
            "address_2": "8TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071519",
            "telephone_number": "215-762-4005",
            "fax_number": "215-762-8572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREXEL UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2014-07-08",
        "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": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drexel Vascular Surgery",
            "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 Jul 8, 2014; 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.