Individual provider Active NPI

Emily Yian Ren, MD

  • Urology Physician
  • Philadelphia, PA
National Provider Identifier
1942040258
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MT230492 Issued in PA
Practice address
3440 N Broad St # 300
Philadelphia, PA 19140-5104
Phone
(215) 707-3632
NPI assigned
May 27, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MT230492 PA Primary

Addresses

Primary practice location

3440 N Broad St # 300
Philadelphia, PA 19140-5104

Mailing address

545 N Broad St Ste 612
Philadelphia, PA 19123-3598

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
I20240603000344 PA Order and Referring Only - UrologyPractitioner - Urology 3870035199

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT230492PAMDUrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1942040258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 N BROAD ST STE 612",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191233598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 N BROAD ST # 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405104",
            "telephone_number": "215-707-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REN",
        "first_name": "EMILY",
        "middle_name": "YIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MT230492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.