Individual provider Active NPI

Patricia Nikitin Ischiropoulos, MD

  • Obstetrics & Gynecology Physician
  • Media, PA
National Provider Identifier
1932204617
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD055778L Issued in PA
Practice address
1098 W Baltimore Pike Ste 3106
Media, PA 19063-5139
Phone
(610) 891-6240
Fax
(610) 891-6244
NPI assigned
Sep 14, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD055778L PA Primary

Addresses

Primary practice location

1098 W Baltimore Pike Ste 3106
Media, PA 19063-5139

Mailing address

1098 W. Baltimore Pike
Suite 3106
Media, PA 19063
Phone (610) 891-6240

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
I20061107000161 PA Practitioner - Obstetrics/Gynecology 3173520020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Alabama School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1098 W Baltimore Pike
Media, PA 19063-5139
Phone (610) 560-8940

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS003041LPAMDFamily Medicine Physician
MD055778LPAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Obstetrics & Gynecology CurrentSince Jul 5, 2017 Accepting new patients
Aria Health Physician Services Past Accepting new patients
Main Line Healthcare PastSince Jul 5, 2017 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1020 Baltimore Pike
Ste 310
Glen Mills, PA 19342
Phone (484) 227-7532

1098 W Baltimore Pike
Ste 3106
Media, PA 19063
Phone (610) 891-6240

1098 W Baltimore Pike
Ste 3303
Media, PA 19063
Phone (610) 532-1300

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

3855 West Chester Pike
Ste 305
Newtown Square, PA 19073
Phone (215) 732-5590

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1932204617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1098 W. BALTIMORE PIKE",
            "address_2": "SUITE 3106",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "610-891-6240",
            "fax_number": "610-891-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 W BALTIMORE PIKE STE 3106",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635139",
            "telephone_number": "610-891-6240",
            "fax_number": "610-891-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISCHIROPOULOS",
        "first_name": "PATRICIA",
        "middle_name": "NIKITIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD055778L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.