Individual provider Active NPI

Amanda Judith Podolski, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1932510260
Registry record updated May 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT206241 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-2969
NPI assigned
May 8, 2014
Last updated
May 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT206241 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3401 N Broad St
Philadelphia, PA 19140-5103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20200820002216 NJ Practitioner - Hematology/Oncology 9032535075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 447-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT206241PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC Internal Medicine CurrentSince Jul 27, 2020 Accepting new patients

Locations

1 Valley Health Plz
Paramus, NJ 07652
Phone (201) 634-5353

1 Valley Health Plz
Ste C212
Paramus, NJ 07652
Phone (201) 634-5578

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

Interoperability endpoints

  • Direct secure messaging: amanda.podolski.1@5622.direct.athenahealth.com

Organizations & group practices 1

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 3

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": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399507200000",
    "number": "1932510260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODOLSKI",
        "first_name": "AMANDA",
        "middle_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-08",
        "last_updated": "2014-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT206241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.