Individual provider Active NPI

Reem Khraishi, MD

  • Student in an Organized Health Care Education/Training Program
  • Philadelphia, PA
National Provider Identifier
1912792078
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
117 South 11TH Street
204 Pavilion
Philadelphia, PA 19107
Phone
(215) 503-3876
NPI assigned
Apr 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

117 South 11TH Street
204 Pavilion
Philadelphia, PA 19107

Mailing address

117 South 11TH Street 204 Pavilion
Philadelphia, PA 19107

Other names 1

  • Reem O M Khraishi Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250709004022 PA Order and Referring Only - PathologyPractitioner - Pathology 6901310069

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1744243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1912792078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 SOUTH 11TH STREET 204 PAVILION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 SOUTH 11TH STREET",
            "address_2": "204 PAVILION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-503-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHRAISHI",
        "first_name": "REEM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-10",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REEM O M",
            "last_name": "KHRAISHI",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.